Paper short abstract:

Based on an ethnography conducted in a day care center for elderly people with dementia, the literature describing them as disengaged bare bodies, denied of subjectivity and humanity, is challenged. An alternative approach suggesting a spiraling process of re-engagement is propounded.

Paper long abstract:

We challenge the assumption that an entrance into a total instituion forfeits the body of subjectivity; self, social roles and rights; thus turning it into an object of bare life. Furthermore, we contest the vast literature describing elderly pepole with dementia as individuals subjected to a spiraling pejorative process gradually denying them of subjectivity and humanity; thus rendering them susceptible to "social death" management, as mere objects of treatment.

Our research is based on an ethnography we carried out among elderly people, attending a day care center, in moderate to advances stages of dementia.

Our findings suggest that on many occasions the nursing home staff infantilizes the elderly people and reproach them; continue their assignments without attending to their presence and wishes; abstaining from the elderly people, demonstrating that they are their superiors.

Nonetheless, they frequently jest with the elderly people; play with them and stay attuned to their rhythm, without displaying any form of impatience. Moreover, they encourage them to walk or rely on crutches, in order to prevent them from being marooned to a wheelchair. The staff challenges them and makes efforts to pay attention to the activies that the elderly people prefer to engage with. Finally, the staff compliments the elderly people and respects their preferences.

These complex relationships challenge Goffman's and Agamben's assumptions and form a unique oppportunity to debate on the different components of the "self", especially when it is symbolically becoming extinct; while the leftovers of the "subject" remain, though supposedly invisible and inactive.

Paper short abstract:

Focusing on the narratives of staffs working at an institution in Sri Lanka, this paper explores how they strive to define their interaction with dying residents, in an ethical way. While analyzing its socio-cultural contexts, it also tries to rethink our ethical assumptions on end-of-life care.

Paper long abstract:

While majority of older Sri Lankans still live with their children, roughly 200 old age homes are providing social safety nets for those who lack familial support. In this presentation, through a case study of one institution on southwest coast of Sri Lanka, I explore how the staffs practice end of life care for the residents, and how they strive to define their relation with dying residents, in an ethical way. Ageing and, especially dying in institutions without support from one's family is a painful experience for both the residents and staffs. The staffs expressed 'kalakirima' or despair with life while caring for the dying residents, and further went on to say that their lives were "not worth living." Such response at first gave me a negative impression that they were looking down upon the suffering of residents without any moral imagination. However, a careful look at the staffs' narratives compels us to take a different perspective. Staffs were emotionally involved in the suffering of residents because they themselves were subject to similar kinds of suffering; suffering due to dying, and to the contingency of life. They practices as good care as they could because they would be treated in the same way if they were to enter such institutions in the future. While analyzing how socio-cultural values shape such narratives, I try to find common ground between the staffs' ethics and ours, and to rethink our familiar ethical assumptions surrounding the end of life care.

Paper short abstract:

Adult children are the primary decision-makers in end-of-life care in China, with options limited by Chinese culture and policies. Views of end-of-life care are changing as new generations confront what it means to be a filial China as new care models emerge and family dynamics change.

Paper long abstract:

Filial piety is a key moral virtue and central to the Chinese identity. Ancestors were once worshipped and had power to influence the fortunes of the living. What does this mean to those approaching the end of life in China today, after the turmoil of Mao's revolution, three decades of reform and breakneck economic growth, and a rapidly aging society where most families have been allowed only one or two children? Interviews and observations with medical staff, families, patients, and officials in Shanxi province reveal that end-of-life care in China is riddled with challenges and contractions. Considering the dying as ancestors highlights the changing role of elders in Chinese society, as families navigate changing policies, new wealth, and altered family structures. While the government increasingly throws resources at healthcare and old-age care, little assistance is available in the end of life. Hospitals fear the wrath of families of patients who die in hospitals, and children fear being seen as unfilial. The dying are not told they are dying, and have little say in care decisions. People express dissatisfaction with this state of affairs, but also a sense of being trapped by family, by culture, and by a simple lack of options. Even as people try to find the problem in the core of Chinese ethnicity and culture, these narratives reveal that the Chinese culture is embedded in ever-emerging historical circumstances. New policies, family structures, and moralities will continue to change end-of-life care for each successive generation.

Paper short abstract:

This paper analyzes the link between aging and care under the structural change of the local welfare system in Finland. By describing home care deployment in a small municipality, a series of choices by the elderly under the pressure of politics and the struggle over subjectivity are taken into account.

Paper long abstract:

Life as an aging process is a series of choices. As one gets aged, he/she needs to make choices for life more and more. How long does one can continue living at home? When does one should start seeking outside help? In social democratic welfare states, these choices are to be made within the social welfare domain. Therefore, current structural change of the local welfare system in Finland invokes new series of life choices made by care recipients. The pressure of deinstitutionalization promotes home care services, urges elderly people to stay at home longer than before, and requires more effort of those elderly to live independently. Under these circumstances, what kind of care and living arrangements do elderly people choose to have? Is this series of choices under the governmental power of biopolitics, or do the elderly care recipients exercise their subjectivity in the new welfare setup?

This paper is to describe the structural change of the local welfare system in Finland and how this change rearranges the life of elderly people in need of care. Example will be taken from a municipality in southwestern Finland, where the local welfare composition is modified by severe deinstitutionalization. For those who want to stay at home, how are their life choices and their course of aging intertwined to each other? By describing that, I would like to get some insights into the aging and subjectivity of elderly in the welfare states in transition.

Paper short abstract:

This paper tracks the emergence of a new ontology of aging that has spread through regional government efforts to prevent enrollment in Japan's national Long Term Care insurance, and scientific and academic research into the prevention of care.

Paper long abstract:

The Aging Society Crisis (shōshikōreika shakai mondai) in Japan represents a point of saturation, when the numbers of elderly in-need-of-care exceed the available financial resources and labor-power, leading to economic, societal, and national collapse. The counter-measures implemented by the national government have included efforts to limit the number of elderly enrolled in Japan's national Long Term Care (LTC) insurance, through health-care prevention measures.

Beginning with the enactment of Japan's national Long Term Care insurance in 2000, this paper tracks the emergence of a new ontology of aging and old age that has spread through regional government efforts to prevent enrollment in LTC and scientific and academic research into the prevention of care - specifically, as Kaigo-yobo, Locomotive Syndrome Prevention, and Mibyo Naosu. What is of interest both ethnographically and theoretically is the degree of sameness underlying these various preventive approaches, particularly in their mobilization of certain notions of health and the human condition and its relation to idealized social- and natural-living environments. I discuss how these three prevention initiatives mobilizes a human ontology of spontaneous self-emerging energetics. It follows that every person has a predetermined wellspring of energy that, if unhindered by opposing forces, will maximize its energetic potential over the course of time, resulting in "the good death." Sociality and environmental life-worlds have also been refigured, aligning with emerging ontologies of healthy aging and old age in Japan.

Paper short abstract:

Solitary deaths have been identified as a problem for aging urban communities. This paper examines the ways in which caregivers take on the affective labor of watching older adults. It raises questions about the ways feelings about death inform care practices and political subjectivity.

Paper long abstract:

Deaths that go unobserved or unnoticed are messy, disorganized, and cast a shadow over efforts to encourage a sense of community connectedness and belonging. Deaths of solo-dwelling older adults in particular, expose the precarious bonds of communities in a literally visceral and unsettling manner. Solitary deaths also expose the perpetually contested roles and responsibilities of the older individual, their family, community volunteers, and the state. The problem is not death, but death in the absence of affective bonds of care by responsible others. This paper presents a view of solitary death from the perspective of caregivers at the end of life, including interviews with local community volunteers who look after solo-dwelling older adults, geriatric nurses, and older, solo-dwelling individuals themselves. In each case, I examine the meanings and motivations for care, looking at the ways it shapes political subjectivity and the economy of affective labor within the broader context of Japan's aging society, changing policies and local cultural and demographic change.

Paper short abstract:

By focusing on an underclass enclave in Yokohama City dubbed "the homeless town," this paper demonstrates the emergence of new ethics and technologies of care precipitated by the imagery of bestial death in Japan.

Paper long abstract:

From appalling gang assaults on the homeless to isolated deaths in flophouses, this paper explores how certain forms of death came to occupy a central place in the discourses and practices of homeless activism in Japan over the past few decades. By focusing on an underclass enclave in Yokohama City dubbed "the homeless town," this paper demonstrates the emergence of new ethics and technologies of care precipitated by the imagery of bestial death. While the mob killings of the homeless in Yokohama in the early 1980s ignited the movement to secure the right to survival with its foothold in a former day laborers' district, the meaning of survival became questionable when the fear of facing isolated death and becoming an unattached wandering soul overwhelmed those rescued. Eventually, the homeless activism in Yokohama came to incorporate social activities and mortuary rituals to prevent the worst forms of death and appease the lonely souls of the deceased. As a result, "the homeless town" became like a mortuary where the body is encased, monitored and attended to by many agents working together to facilitate the transition into the next stage of existence. By illuminating how the meaning of life of the homeless was to be realized by securing a dignified death and afterlife in "the homeless town" in Yokohama, this paper suggests that death came to provide powerful idioms and images to make claims for life in Japanese society in the wake of a prolonged recession coupled with a rapidly aging population.

Paper short abstract:

This paper will deal with the multiple levels (practical as well as symbolic) that an immigrant´s death in contemporary Portugal touches upon, from the symbolic to the more practical ones. It will analyze the case studies of migrants from Guinea-Bissau.

Paper long abstract:

In spite of the interest that the recent status of Portugal as an immigration country arises, some important issues dealing with immigrant´s states of suffering and death, have hardly been dealt with. For immigrants themselves, this is a reality that often conditions the relation with the home country. Death is thus here looked upon as a process, which involves specific emotional states and triggers the use of rituals in order to cope with the unavoidable distress, acquiring more complicated aspects when away from home.

This paper will deal with the multiple levels that death touches upon, from the symbolic to the more practical ones. Death is one realm in which a transnational approach is mandatory; it entails an intense circulation of material goods and wealth, but also of highly symbolic significant universes which circulate along with the goods and the people: the corpse, but also the spirits and the relations with the other world that people brought along into the diaspora situation. This paper aims at deconstructing prejudiced notions of what happens with the immigrants´ dead bodies, including symbolic representations as well as practical issues, such as legal processes involved to send the bodies home, using as case studies the immigrants from Guinea-Bissau in contemporary Portugal. Based on ethnographic data, it will deal with the work done by immigrants´associations, and other intervenient in the process-- hospitals, funerary agencies, diplomatic and border authorities and religious institutions.