Institutionalizing Old Age: Living with Dementia in the Anthropocene

Background. The aging of the population is often celebrated as a triumph for humanity, partially due to progress in biomedical sciences. While these technological advancements in healthcare have allowed people to avoid or better manage illness and frailty for longer, society has yet to provide those reaching old age with meaningful and fulfilling lives. The emphasis on compulsory youthfulness, coupled with ageist attitudes, has stigmatized frailty and loss of autonomy, rendering older adults with dementia among the most marginalized members of the aging population. In response to the increasing demand for care, and in an unstable societal context where governments have resorted to institutionalizing older adults in long-term care facilities reminiscent of early 20th-century asylums, the disjunction between the everyday lives of institutionalized older adults and the pressing challenges of the Anthropocene raises important questions. How did aging transform from a "triumph" to a "burden"? What does it mean to be an older adult with dementia in a neoliberal, capitalist society?

Methodology. To better understand the reality of this population, an institutional ethnography was conducted in a long-term care home in Québec, Canada. Data generation process included analyzing institutional discourse, participant observation spanning over 6 weeks (133 hours) and non-directed leisure-based interviews with residents with dementia (n=4).

Results and discussion. Our results notably put in light how institutionalized older adults with dementia ultimately endorse the burden of being "the good resident” in a fast-paced system that is not built around them, notwithstanding what governmental policies suggest. For public healthcare systems to adapt to older adults’ needs, and truly put them in at the center of their own care, substantial changes must be made at the population and institutional levels. Our societies must reconcile the human desire to grow older and the dehumanization of our daily practices.