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Forgetting and Forgotten: Dementia in Aboriginal Seniors

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Our research concerns Alzheimer’s Disease and Related Dementias (ADRD) in Aboriginal communities in Ontario, Canada. The title “Forgetting and Forgotten” is meant to convey that like mainstream society Aboriginal communities are also experiencing high rates of ADRD as their senior population increases. However because of historically low rates of ADRD in these communities their specific needs as Aboriginal people are overlooked by mainstream service providers as well as by the government funding agencies that provide services on reserve. Our research aims to bring light to this new health issue through community-based anthropological investigations into the experience of ADRD in diverse Aboriginal communities in Ontario. The preliminary results highlighted here focus primarily on the cultural influences on the experiences of ADRD in this population at two of our research sites: (1) The Haudensaune Six Nations Reserve in Southern Ontario and (2) the seven rural Ojibwa, Odawa, and Pottawatomi First Nations of Manitoulin Island in Northeastern Ontario. Our methodology is community-based and participatory and is qualitative. At each site semi-structured depth interviews were conducted by the authors and community based researchers with: seniors (≥55); persons with dementia (PWD); family caregivers for PWD; health care providers for PWD; and key informant interviews with physicians, traditional knowledge keepers and healers, and specialists (Manitoulin Island n=20; Six Nations n=16). Focus groups with Personal Support Workers were also carried out in each location. The preliminary results presented concern the similarities and diversity in the experience, knowledge and traditions of Aboriginal people with ADRD at these two culturally distinct sites.
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Anthropology & Aging Quarterly 2012: 33 (1) 1
Anthropology & Aging Quarterly
February 2012
Volume 33, Number 1
Anthropology & Aging Quarterly 2012: 33 (1) 2
Anthropology & Aging Quarterly, Vol. 33, No. 1, February 2012. This periodical is printed quarterly and is produced by the Association for
Anthropology & Gerontology (AAGE). Subscriptions are available through membership in AAGE. Correspondence regarding membership may be
directed to the AAGE Treasurer, Sharon Williams, Ph.D., Assistant Professor of Anthropology, Department of Anthropology, Purdue University, 700
W. State St., West Lafayette, IN 47907. Annual membership fees and forms may be accessed through the AAGE website: www.aage.clubexpress.com
Anthropology & Aging Quarterly
The ofcial publication of the Association for Anthropology & Gerontology
Judith Corr, Ph.D.
Grand Valley State University
Howie Giles, Ph.D.
University of California Santa Barbara
Madelyn Iris, Ph.D.
Council for Jewish Elderly
Sarah Lamb, Ph.D.
Brandeis University
Dawn Lehman, Ph.D.
MatherLifeways
Annette Leibing, Ph.D.
Université de Montreal
Mark Luborsky, Ph.D.
Wayne State University
Jon Nussbaum, Ph.D.
Pennsylvania State University
Catherine O’Brien M.A., MPH.
MatherLifeWays
Margaret Perkinson, Ph.D.
Washington University
Dena Shenk, Ph.D.
University of North Carolina, Charlotte
Samantha Solimeo, Ph.D., MPH
CADRE, Iowa City VA Medical Center
John Traphagan, Ph.D.
University of Texas at Austin
Book Reviews Editor
Sherylyn Briller, Ph.D.
Student Column Editor
Philip Kao, Ph.D. Candidate
New Publications
Maria G. Cattell, Ph.D.
Member News
Margaret Perkinson, Ph.D.
President Lori Jervis, Ph.D.
Center for Applied Social Research, University of Oklahoma, 2 Partners Place, 3100 Monitor Avenue, room 100, Norman, Oklahoma 73072
E-mail: lori.jervis@ou.edu
Immediate Past-President Sherylyn Briller, PhD
Department of Anthropology, 3054 Faculty/Administration Building , 656 Reuther Mall, Wayne State University, Detroit, MI 48202
E-mail: s.briller@wayne.edu
Elections Chair Rebecca Berman, Ph.D.
Buehler Center on Aging, Northwestern University, 750 N. Lakeshore Drive, , Suite 601, Chicago, IL 60611-2611
E-mail: r-berman2@northwestern.edu
Treasurer Sharon Williams, Ph.D.
Department of Sociology and Anthropology, Purdue University, 700 W. State St., West Lafayette, IN 47907
E-mail: srw@purdue.edu
Secretary Eric Miller, PhD
Program Director Education Abroad, Virginia Polytechnic Institute and State University, 526 Prices Fork Rd., Blacksburg, VA 26060
E-mail: etmiller@vt.edu
AAGE Booth Coordinator Maria G. Cattell, Ph.D.
486 Walnut Hill Road, Millersville, PA 17551
E-mail: mgcattell@aol.com
Margaret Clark Award Coordinator Mark Luborsky, Ph.D.
Institute of Gerontology, Wayne State University, 87 E. Ferry Street, Room 252, Detroit, MI 48202
E-mail: m.luborsky@att.net
AAQ Editor Jason Danely, Ph.D.
Department of Anthropology, Rhode Island College, 600 Mt Pleasant Ave. ,Gaige 111, Providence, RI 02909
E-mail: jdanely@ric.edu
Website Editor Bob Schrauf, Ph.D
AAGE Ofcers
(ISSN: 1559-6680)
Editor
Jason Danely, Ph.D.
Section Editors
Editorial Board
Anthropology & Aging Quarterly 2012: 33 (1) 3
Anthropology & Aging Quarterly
February 2012
Volume 33, Number 1
Contents
Columns
From the AAGE President
Lori L. Jervis •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••4
From the Editor
Jason Danely••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••4
New Publications in Anthropological Gerontology
Maria Cattell ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••6
ConferenCe report
2009 American Anthropological Association Meeting, New Orleans, LA, Session on Culture,
Health and Aging in Native North American Communities
Introduction Wayne Warry ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••10
Marie’s Story Of Aging Well: Toward New Perspectives on the Experience Of Aging For Aboriginal Seniors in
Canada Syvia Abonyi Marie Favel, Ile a la Crosse
Mistreatment and the Meaning of Respect for Native Elders Lori L. Jervis William Sconzert Hall
Forgetting and Forgotten: Dementia in Aboriginal Seniors Kristen Jacklin and Wayne Warry
Understanding Aging: Culture, Cognitive Health and Contemporary Aboriginal People’s Experience with Dementia
Jessica Pace
Perspectives on Brain Autopsy, Diabetic Amputation, and End-of-Life Issues among Elderly American Indian
People Neil Henderson, L. Carson Henderson, Ryan Blanton and Steven Gomez
Discussion Robert C. Harman and Wayne Warry
AAGe Business
AAA Interest Group on Aging & the Life Course Report
Jay Sokolovsky •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 17
Member News
Margaret Perkinson •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••23
New Editorial Board Members Introductions
Jason Danely•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••23
Information for Contributors and Submission Deadlines•••••••••••••••••••••••••••••••••••••••••••25
reviews
The Person in Dementia: A Study of Nursing Home Care in the U.S. (Athena McLean)
Elizabeth K. Briody •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 18
Ten More Good Years (Michael Jacoby)
Terri Ann Liller •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 19
Anthropology & Aging Quarterly 2012: 33 (1) 4
President’s Message
Lori L. Jervis, Ph.D.
Department of Anthropology and Center for Applied Social Research
University of Oklahoma
Greetings, AAGErs!
AAGE met twice this fall as usual, at the American Anthropological Association Meeting in Montreal, Quebec on
November 19th, as well as at the Gerontological Society of America Meeting in Boston on November 20th, 2011. It is
interesting serving an organization whose membership is divided (or torn?) between these two national organizations,
whose annual meetings nearly always occur at the same time. If only we could be in two places at once!
Samantha Solimeo, a long-time AAGE member, was voted President-Elect of the AAGE. She will assume the Presidency
in Fall 2012. Congrats, Samantha!
Our website continues to serve us well. Thanks to Robert Schrauf for keeping it going! Jason Danely has made a number
of improvements that have improved the website’s aesthetic appeal. Speaking of technology, did you know that
AAGE has an Anthropology and Gerontology Facebook page? Examples of recent postings: An article on the economic
wellbeing among older Americans, a video on LGBT elders, and a posting on the AAA Aging and the Life Course
Interest Group. This is another way for us to communicate with each other and share mutually benecial information.
Please join in, if you haven’t done so already.
To keep doing what we are doing—and to do more for our members— takes funds. Getting those expired memberships
renewed is a high priority for AAGE. If your membership has expired (or if this applies to someone you know), please
renew. It only takes a few minutes at https://aage.clubexpress.com/content.aspx?page_id=0&club_id=497336. While
you are at it, please update your prole in the membership directory.
As for the future, we are thinking ahead to the next annual AAGE conference. If you think you might be interested in
hosting the next annual AAGE conference or would like more information, please contact me at lori.jervis@ou.edu.
Until next time!
From the Editor
Jason Danely, Ph.D.
Department of Anthropology
Rhode Island College
The continued rise of interest in anthropological perspectives on aging and the life course presents incredible
opportunities for the future of AAQ. As editor, I realize both the potentential and the challenge of staying at the center
of new research and scholarly activities, which, like other elds, is increasingly global, digital and interdisciplinary. In
consdieration of these factors, I have planted a few seeds of change for this year’s AAQ that I invite all of us to watch
over as they spring up. These include:
• New designs and accessibility options, including greater uidity with the AAGE website
• Diversication of submission categories to include new media, pedagogy, interviews and dialogues
• Expansion of the editorial board to accomodate more and diverse submissions
• More issues dedicated to special topics in aging and anthropology
• Public, searchable online access to selected content through our website
• Increased graphics content, especially photographs of AAGE members
These changes will be gradually phased in over the next two years. In the meantime, AAQ will continue to bring
members regular content, such as commentaries and reviews; eld, research and conference reports; and carefully
reviewed articles from both junior and senior scholars around the world. The current issue contains some great
examples of this, with a detailed report on aging in Native American communites and two timely book reviews. I will
also be introducing new members of the AAQ editorial board beginning with this issue, and encourage everyone to
continue submitting content for them to look at. Looking forward to an exciting 2012 at AAQ!
Anthropology & Aging Quarterly 2012: 33 (1) 5
New Publications in Anthropological Gerontology
Maria G. Cattell
It’s snowing as I write this. But I know that under the
snow, snowdrops and aconites are a-bloom. And if you’ve
been hiding your latest publications under some bushel,
please let me know about them–things I’ve missed,
book chapters, articles in specialized journals, whatever:
mgcattell@aol.com.
ABBREVIATIONS: AI=Ageing Inter-national;
A&S=Ageing & Society; EJA=European J.Aging;
Geront.=The Gerontologist; JAH=J.Aging & Health;
JAHA=J.Aging, Humanities & the Arts; JCCG=J.
Cross-Cultural Gerontology; JG=J. Gerontology
(P=Psychological; S=Social); JPA=J.Population Aging;
QHR=Qualitative Health Research.
*Name in boldface indicates AAGE member.
About a former member, by himself:
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Changing an academic career into a professional calling.
In The Tao of Anthropology, ed. A.J. Kelso. Pp. 201-225.
Gainesville: University Press of Florida.
(I have fond memories of Otto, who died in December
2010.)
Aging
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Friedman, H.S. & L.R. Martin 2011 The longevity project:
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landmark eight-decade study. NY: Hudson Street Press.
Friedman, M. 2011 The big shift: Navigating the new stage
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resilient aging: Life strengths and well-being in late life.
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Margolies, L. 2010 The anthropologist as caregiving
daughter: Lessons from the world of the frail elderly.
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McFadden, S.H. & J.T. McFadden 2011 Aging together:
Dementia, friendship, and ourishing communities.
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ndings and future trends. JG/PS 65B(2):135-144.
Settersten, R.A. Jr. & J.L. Angel, eds. 2011 Handbook of
Congratulations to
*Caitrin Lynch for her new book due out in 2012 Retirement on the line: Age, work, and
value in an American factory. from LR Press/Cornell University Press!
Anthropology & Aging Quarterly 2012: 33 (1) 6
New Publications in Anthropological Gerontology
sociology of aging. NY: Springer.
Biogerontology
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Research in Europe.”
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and the ‘denaturalisation’ of caregiving in Quebec. A&S
31(7):1141-1158.
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conceptualizations and divergent experiences of
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long-term care: Participatory action research and the role
of the resident. Geront. 51(2):212-225.
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caregiving in the United States. NY: Springer.
Comparative Perspectives: Cross-Cultural & Cross-
National
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30(6):987-1009.
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old-age income protection in Korea and Taiwan. A&S
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generations: On the strength and character of family
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practical help between older parents and their middle-
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demographic, economic and structural correlates of
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36(4):428-444.
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count on support from adult children? Implications of
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of children in relieving elder poverty: Evidence from
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New Publications in Anthropological Gerontology
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The experiences of dementia across three ethnic groups
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demography: Representations of population ageing in the
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caregivers and HIV/AIDS-related secondary stigma in
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Temporality in return migration to Spain. JAHA 4(2):110-
118.
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carers reasoning about death and dying in nursing homes
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51(2):238-250.
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challenge. AI 36(4):423-427.
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co-residence of parents and children among older Kuwaiti
men and women: What are the signicant correlates?
JCCG 26(2):157-174.
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Social Indicators Research 105(2) 2012 Special issue on
“Comparing the well-being of older Europeans.”
Tohme, R.A. et al. 2011 Socio-economic resources and
living arrangements of older adults in Lebanon: Who
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Comparative Perspectives: Ethnicity in the U.S. & Canada
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obligation and their impact on preferences for future living
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New Publications in Anthropological Gerontology
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Demography
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Ethics
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Family Matters
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American 305(2):45-49.
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Gender Issues
Clarke, L.H. 2011 Facing age: Women growing older in
anti-aging culture. Lanham MD: Rowman & Littleeld.
Gerontology
Phillips, J., K. Ajrouch, S. Hillcoat-Nallétamby, eds. 2010
Key concepts in social gerontology. London: Sage.
Health
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Humanistic Perspectives
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Lustbader, W. 2011 Life gets better: The unexpected
pleasures of growing older. NY: Torcher.
Nanda, S. & J. Gregg 2011 Assisted dying: An
ethnographic mu rder mystery on Florida’s Gold Coast.
Lanham MD: AltaMira.
Smith, G.J. 2010 Old Maine woman: Stories from the coast
to the county. Yarmouth ME: Islandport.
Anthropology & Aging Quarterly 2012: 33 (1) 9
New Publications in Anthropological Gerontology
Whitman, L., ed. 2010 Telling tales about dementia:
Experiences of caring. London: Jessica Kingsley.
Narrative Gerontology
Kenyon, G., E. Bohlmeijer, W.L. Randall, eds. 2011
Storying later life: Issues, investigations, and interventions
in narrative gerontology. NY: Oxford UP.
Policy
Beer, A. & D. Faulkner 2011 Housing transitions through
the life course: Aspirations, needs and policy. Bristol UK:
Policy Press.
Cann, P. & M. Dean 2011 Unequal ageing: The untold
story of exclusion in old age. Bristol UK: Policy Press.
Grenier, A. 2012 Transitions and the lifecourse:
Challenging the constructions of ‘growing old’. Bristol UK:
Policy Press.
Tanner, D. 2010 Managing the ageing experience: Learning
from older people. Bristol UK: Policy Press.
Religion & Spirituality
Bouwer, J., ed. 2010 Successful ageing, spirituality and
meaning: Multidisciplinary perspectives. Walpole MA:
Peeters.
Coleman, P.G. 2011 Belief and aging: Spiritual pathways
in later life. Bristol UK: Policy Press (Ageing & Lifecourse
Series).
Richmond, L. 2012 Aging as a spiritual practice: A
contemplative guide to growing older and wiser. NY:
Gotham.
Research Issues
Ageing & Society 31(3) 2011: Special issue on
“Methodologies for ageing populations.”
Bytheway, B. 2011 Unmasking age: The signicance of age
for social research. Bristol UK: Policy Press.
Hennessy, C.H. & A. Walker 2011 Promoting multi-
disciplinary and inter-disciplinary ageing research in the
United Kingdom. A&S 31(1):52-69.
Lowenstein, A., R. Katz, S. Biggs 2011 Rethinking
theoretical and methodological issues in intergenerational
family research. A&S 31(7):1077-1083.
*Schweitzer, Marjorie M. Age is more than a number.
In Expanding American anthropology 1945-1980: A
generation reects. A.B. Kehoe & P.L. Doughty, eds. Pp.
50-57. Tuscaloosa: U of Alabama Press.
Tyler, D.A. et al. including *Renée R. Shield 2011 How
valid are the responses to nursing home survey questions?
Some issues and concerns. Geront. 51(2):201-211.
Retirement
*Lynch, Caitrin 2012 Retirement on the line: Age, work,
and value in an American factory. Ithaca: ILR Press/
Cornell UP.
Theory
Adams, K.B., S. Leibbrandt, H. Moon 2011 A critical
review of the literature on social and leisure activity and
wellbeing in later life. A&S 31(4):683-712.
McDonald, L. 2011 Theorising about ageing, family and
immigration. A&S 31(7):1180-1201.
Pearlin, L.I. 2010 The life course and the stress process:
Some conceptual comparisons. JG/SS 65B(2):207-215.
Anthropology & Aging Quarterly 2012: 33 (1) 10
Introduction
Wayne Warry
Anthropology
McMaster University
In June 2009 Lori L. Jervis organized a meeting on ‘Aging and the Indigenous Peoples of
America’ in Norman, Oklahoma that was sponsored by the Association of Anthropology
and Gerontology. The idea of organizing a session for the 2010 American Anthropological
Association meetings in New Orleans arose at this meeting. Subsequently Lori L. Jervis
and I organized a session titled ‘Culture, Health and Aging in Native North American
communities.’ This article summarizes the papers and presentations given at that session.
As noted in the AAA Session Abstract, despite the often-stated value of Elders as cultural
resources and spiritual leaders, little is known about the actual contemporary social and
health statuses of Native North American Elders. The anthropological and health science
literature on older Native people is sparse; by some accounts less than 2 percent of all
studies focus on seniors. In the United States and Canada the percentage of older Native
peoples are projected to double in the next decade. Despite these projected increases, the
number of anthropologists studying aging in Native populations has remained small.
This AAA session brought together anthropologists from Canada and the United States
who are engaged in research with Native/Aboriginal Elders in order to examine how
anthropological approaches may further our understanding of this small, but growing
component of the Native population— one which has traditionally been inuential
beyond their numbers with respect to their roles as culture bearers and socializers
of future generations. What follows are short summaries of these presentations and
papers, following the order of presenters at the session.
Conference Report: 2009 Meeting of the American Anthropological Association
Session on Culture, Health and Aging in Native North American Communities
Anthropology & Aging Quarterly 2012: 33 (1) 11
Conference Report: 2009 Meeting of the American Anthropological Association
Session on Culture, Health and Aging in Native North American Communities
Marie’s Story Of Aging Well: Toward New Perspectives On The Experience Of Aging For
Aboriginal* Seniors In Canada
Sylvia Abonyi, University of Saskatchewan and Marie Favel, Ile a la Crosse, Saskatchewan, Canada
This paper, co-authored by a university researcher (Sylvia) and an Aboriginal community Elder (Marie), considers the
construction of a framework of healthy aging for Aboriginal peoples in Canada. There has been limited work in this
area, and a clear need for it identied as the cohort of aging Aboriginal people in Canada grows. Our contribution
begins with Marie’s story of aging well as a launch point from which we plan to collect more stories like hers. Our goal
is to build a framework of aging well within which to locate issues like dementia, cancer, and other challenges of aging
that are emerging for Aboriginal peoples. Many of these challenges are not unique to Aboriginal populations, but their
magnitude and manner of expression and the colonial context in which they have unfolded is different from other
populations in Canada, demanding that we build our understanding anchored in these realities. Research by Collings
(2001) with the Inuit, and by Edge and McCallum with Métis (2006) noted that the most important determinants of
successful aging for their participant groups are ideological (rather than material), noting the importance of history,
culture, and language, as well as their successful transmission to new generations, for understanding the health,
healing, and wellness needs of these populations. As Marie’s story reveals, these ideological themes, coupled with their
transmission to younger generations, are key elements of her life as well.
Marie: A Brief Biography: Marie was born in 1939 and has lived most of her life in and around the Métis community of
Ile a la Crosse in Saskatchewan, Canada. She married her husband Jimmy in 1958 and over the next 58 years she raised
8 children, became a teacher, a religious educator, a community health worker, and an advocate for the inclusion of
Aboriginal inuence in the education and governance of their people. Throughout this time she attended post-secondary
training, worked with her husband to help him overcome an alcohol addiction, and together they reconnected with their
Aboriginal heritage. She does not see herself as a strong person, but points to people around her, such as Jimmy, as her
source of strength. Together they are dealing with health challenges that come with aging and at the same time continue
to make tremendous contributions to the well being of their community and the Métis nation in Saskatchewan. As she
looks back on her life, Marie observes:
“…I see that I have moved through the medicine wheel; that my pursuit of more education and experience has taken me
through all four quadrants as a teacher (mental & emotional), as a religious educator and sweat leader (spiritual), and
in community health education (physical). And having searched the wheel I found the last piece in health education.
And this is where I feel I can make the most contribution to the health and healing of my community. So today I am
still involved in many things that are about sharing my life experiences, about helping our youth stay in school, about
helping our young people parent well and drawing on the old ways, and about dealing with the hurt that is still there in
the high suicide rates among our youth. ”
Frameworks for understanding aging experiences for older Aboriginal people:
As Marie and I talk about her story we see there are some important elements of her aging well experience that need to
be reected in frameworks that we might develop to explore other stories of aging for Aboriginal people. Central is the
signicance of her ongoing contributions to community life. It is clear that she is valued in this role as she can scarcely
keep up with the invitations to present in classrooms, workshops, and conferences. Consistent with Collings (2001)
research among the Inuit for successful aging, Marie is dedicated to the transmission of her accumulated knowledge and
wisdom to younger generations. Her capacity to engage in this way has its roots earlier in her life, when she was able
to pursue her passion for further education, to advocate for the inclusion of Aboriginal voices where there were none,
and importantly, to connect with cultural traditions that were denied to her earlier in life. These latter two factors are
directly linked to the colonial context of Aboriginal populations in Canada. These linkages to culture and agency are
also important aspects for inclusion in any framework that would shape our understanding of aging experiences –good
and bad, for these populations. Marie’s story, and other research, provides evidence that the role and value of older
Aboriginal peoples has remained strong in Aboriginal communities, and has been growing, since they are valued as an
Continued on page 20
Anthropology & Aging Quarterly 2012: 33 (1) 12
Conference Report: 2009 Meeting of the American Anthropological Association
Session on Culture, Health and Aging in Native North American Communities
Mistreatment and the Meaning of Respect for Native Elders
Lori L. Jervis, Anthropology and Center for Applied Social Research, University of Oklahoma, William Sconzert-Hall,
Anthropology, University of Oklahoma and the Shielding American Indian Elders Project Team*
Respect—particularly respect for elders—is frequently said to be a central value in many American Indian communities.
Assertions of its continued cultural salience are often accompanied by the lament that this important value is in decline.
Based on ndings from a community based participatory research study of Native elder mistreatment, we examined
respect as it appeared in the discourse of what constituted good and poor treatment by family members (as broadly
dened) among 100 elders from 2 data collection sites, 50 from a tribal elder center on a northern plains reservation and
50 from Protestant Indian churches in an urban area in the southcentral region of the US. The interview consisted of both
a survey meant to assess the usefulness of several measures of elder abuse, neglect, and nancial exploitation in this
population, as well as a series of open-ended questions that allowed elders to expound on the treatment of elders in their
communities. Nearly ¾ of the sample were female (72%), 46% age 70 or older, 52% married, and 26% spoke their tribal
language moderately to very well.
The scholarly and academic literature on conceptualizations of respect of elders is scarce among all U.S. ethnic groups,
and is especially thin for American Indians. Dillon sees respect as “a particular mode of apprehending something,
which is the basis of the attitude, conduct, and valuing, while “To ignore, neglect, or disregard something, or to dismiss
it lightly, thoughtlessly, or carelessly is to not respect it” (Dillon, 1992:108). Although frequent assertions are made
in Native communities about the importance of respect for elders, the constituent elements of the respect concept are
seldom explicated. It is clear, however, that elderhood without respect is not truly elderhood. In Weibel-Orlando’s
(Weibel-Orlando, 1989:152) distinction between elders and elderlies, she notes that an American Indian elder is
recognized by his/her community for “….one’s embodiment of certain exemplary and ethnically valued traits (e.g.,
sagacity, high moral standards, responsibleness).” An elderly, on the other hand, is dependent, impaired, and non-
productive—a social problem rather than a respected member of the community.
Findings
In this study, no questions were specically asked about respect. Participants were asked what it meant to be treated
well by family members, however. Here, almost ½ of the participants equated respect with good treatment of elders. A
thematic analysis of respect revealed that it had a number of dimensions, with behavior (e.g., the provision of various
kinds of assistance) and status (e.g., exhibiting courtesy, demonstrating admiration, asking for and heeding advice,
and honoring) the most prominent. Disrespect, on the other hand, was often seen as synonymous with mistreatment
(e.g., nancial exploitation or verbal abuse). Some participants presented the disrespect leveled at today’s elders as
unthinkable in comparison to the traditional tribal norms with which they were raised. These changes were often
attributed to assimilation and culture loss, sometimes to alcohol.
In summary, several themes emerged in this study: The continued centrality of respect as a tribal ideal, the decline of
respect as a reality, and the equating of disrespect with mistreatment. The ideational aspects of elder respect are crucial
to understand its prominence in Indian county. If attitudes about respect toward elders have indeed so dramatically
shifted in such a relatively short period of time, presumably this reects a decline in their social worth. Where once,
in the absence of a written tradition, elders would have been highly valued as the transmitters of tribal culture and
history (Weibel-Orlando, 1989), they now must compete with popular culture and a number of pressures that push
people toward a “modern” future where elders’ contributions to the community are not nearly so obvious. Unpacking
the complexities around respect is essential to understanding how elders are treated in tribal contexts, and will be an
important aspect of our continuing analysis.
* The Shielding American Indian Elders Project Team includes David Baldridge, Janette Beals, Connie Bremner, Dedra
Buchwald, John Compton, Alexandra Fickenscher, William Foote, Julie Holden, Yvonne M. Jackson, Lisa James, Chebon
Kernell, Anne Libby, Crystal LoudHawk-Hedgepeth, Spero M. Manson, Traci McClellan-Sorell, Lisa Nerenberg, Emily
Matt Salois, Bessie Smith, Charlene Smith, and Gloria Tallbull.
Continued on page 20
Anthropology & Aging Quarterly 2012: 33 (1) 13
Conference Report: 2009 Meeting of the American Anthropological Association
Session on Culture, Health and Aging in Native North American Communities
Forgetting and Forgotten: Dementia in Aboriginal Seniors
Kristen Jacklin, Human Sciences, Northern Ontario School of Medicine and Wayne Warry, Anthropology, McMaster University
Our research concerns Alzheimer’s Disease and Related Dementias (ADRD) in Aboriginal communities in Ontario,
Canada. The title “Forgetting and Forgotten” is meant to convey that like mainstream society Aboriginal communities
are also experiencing high rates of ADRD as their senior population increases. However because of historically low
rates of ADRD in these communities their specic needs as Aboriginal people are overlooked by mainstream service
providers as well as by the government funding agencies that provide services on reserve. Our research aims to bring
light to this new health issue through community-based anthropological investigations into the experience of ADRD in
diverse Aboriginal communities in Ontario.
The preliminary results highlighted here focus primarily on the cultural inuences on the experiences of ADRD in this
population at two of our research sites: (1) The Haudensaune Six Nations Reserve in Southern Ontario and (2) the seven
rural Ojibwa, Odawa, and Pottawatomi First Nations of Manitoulin Island in Northeastern Ontario. Our methodology
is community-based and participatory and is qualitative. At each site semi-structured depth interviews were conducted
by the authors and community based researchers with: seniors (≥55); persons with dementia (PWD); family caregivers
for PWD; health care providers for PWD; and key informant interviews with physicians, traditional knowledge keepers
and healers, and specialists (Manitoulin Island n=20; Six Nations n=16). Focus groups with Personal Support Workers
were also carried out in each location. The preliminary results presented concern the similarities and diversity in the
experience, knowledge and traditions of Aboriginal people with ADRD at these two culturally distinct sites.
Preliminary Results
Differences in access to health care resources are evident between the sites. At Six Nations we see a high degree of
medical system involvement in public education, diagnosis and care for people with symptoms of dementia. On
Manitoulin Island where medical services are more restricted and focused on primary health care we see much less
involvement from physicians and specialists and very few reports of ofcial diagnoses or screening. Other than those
who are in nursing homes, at both sites we have found very few people on prescription medications for dementia.
The analysis of the interview data has revealed that these two different cultural traditions display many similarities in
the way people describe understandings of ADRD and cognitive health. At both sites respondents spoke about how
their culture helps them cope and care for those with dementia. For example, cultural beliefs around the role of family
was a positive inuence on the experience of ADRD; the value of humour is important in coping with ADRD in the
family and community; and Aboriginal language use was highlighted as an important part of caring. Further similarities
between the sites are noted in relation to understandings of prevention and overall cognitive health. Seniors at both
sites noted that listening to Indian music or language tapes, speaking the language, storytelling, taking Indigenous
medicine for ailments, and participating in ceremony are good for keeping your mind healthy. Participants at both sites
also reported that they did not have knowledge of ceremonies specic for dementia but that traditional remedies that
thinned the blood could be used for people with dementia.
Taking an explanatory model approach (Kleinman 1981), we are nding that there are some similarities in the way
people think about and experience ADRD at the two sites. At both locations the majority of participants agreed that
ADRDs are new diseases in various senses: for example, new in magnitude and new in the way people are now being
identied and labeled (i.e., diagnosed). Participants at both sites also suggested that despite the increase in cases, ADRD
was not a major health concern in their community because (1) the majority of people face complex health concerns
and dementia is very low on their health priority list and that of their physicians; and (2) because the symptoms and
behaviours associated with ADRD were consistent with cultural understandings of what is expected as one ages and
becomes closer to the eastern doorway on the medicine wheel. Further to this, some commented that the behaviours
associated with late stage ADRD (what we call hallucinations) set people apart as “special” as they are closer to the
creator. The very idea that “we” would label visions as hallucinations was outright offensive to some participants.
When ideas of causation were explored participants cite causes which can be classied as (1) physiological -- genetics,
aging, brain chemistry, vascular disease, medication side effects and Parkinson’s disease; (2) psychosocial -- unresolved
Continued on page 21
Anthropology & Aging Quarterly 2012: 33 (1) 14
Conference Report: 2009 Meeting of the American Anthropological Association
Session on Culture, Health and Aging in Native North American Communities
Understanding Aging: Culture, Cognitive Health and Contemporary Aboriginal People’s
Experience with Dementia
Jessica Pace, Ph.D. Candidate, Anthropology, McMaster University
Introduction
Past research about aging and health has focused on “the elderly” as a homogenous group, resulting in an
underrepresentation of the unique concerns of marginalized and minority seniors. This bias can be overcome if
researchers attempt to understand the perceived expectations for successful aging of specic groups. Doing so can lead
to a better understanding of the impacts of pressures, such as illness, on the aging process and can create opportunities
for culturally-relevant health promotion. My PhD research attempts to understand expectations for successful aging
among Aboriginal peoples on Manitoulin Island, Ontario with the goal of gaining perspective into the way that
individuals, families and communities in this context react to and cope with the pressures associated with age-related
memory loss and cognitive decline (i.e. Alzheimer’s disease and related dementias [ADRD]). Using qualitative,
ethnographic methods (see Jacklin and Warry, this issue), this community-based research attempts to understand 1)
How culture shapes the experience of being and becoming old in contemporary Aboriginal communities on Manitoulin
Island? And; 2) How perceptions of aging and the elderly impact the knowledge, attitudes, beliefs and behaviours about
ADRD in this context?
Successful Aging and Expectations for Growing Old
Successful aging theory has been critiqued for the use of biomedically-determined criteria for success in aging and
terminology that connotes failure for those who do not achieve these criteria. However, recent research indicates
that a successful aging paradigm can be productive when the criteria used to dene success in old age are drawn
from people in a specic context or community and the focus for success in aging is directed away from physical and
cognitive capacity and towards values, attitudes and behaviours. The relevance of this approach for research with
Aboriginal peoples has been demonstrated in recent research which shows that for Aboriginal peoples success in aging
is characterized more by a positive attitude, ability to manage declining health, community engagement and spirituality
than by good physical health. These ndings are compatible with my PhD research.
Alzheimer’s, Dementia and Successful Aging in Manitoulin Island First Nations
In Manitoulin Island Aboriginal communities aging is expected to be a time of teaching and respect, when family
and community assist seniors when they need help with day to day tasks and activities. For traditionally-oriented
individuals, the process of growing older is shaped by beliefs related to the medicine wheel and the seven Grandfather
teachings, which emphasize balance, respect, teaching, acceptance and maintaining a purpose in life by staying engaged
in social, physical, spiritual, intellectual and emotional realms. Aboriginal seniors have expressed that these teachings
help them to accept the changes that occur as they grow older. Prior research suggests that Aboriginal people are
generally respectful and accepting of seniors with dementia, believe dementia is a natural part of life’s cycle and that the
patient may be moving closer to the creator. Aboriginal people with dementia are thought to be less stigmatized than
their mainstream counterparts, but embarrassment and denial about the condition emerge as symptoms worsen.
Although Aboriginal people on Manitoulin Island are aware that Alzheimer’s disease (AD) exists and that it causes
memory loss, there is little clinical knowledge of what causes AD or that there are other conditions that can cause similar
symptoms. However, experiential knowledge of the symptoms of cognitive decline in old age has resulted in local
explanatory models that accurately describe symptoms of ADRD. These symptoms include memory loss, a tendency to
return to previous life stages, lack of recognition of family members, wandering, suspiciousness and a loss of awareness
of time and place. Beliefs about the causes of memory loss are varied, and include food, environmental contaminants,
stress and emotional trauma, imbalance in the medicine wheel, substance abuse and prescription medications.
Aboriginal people’s beliefs about dementia and cultural tendency for acceptance and respect act as both enablers
and barriers to the care of persons with dementia. Although acceptance can be benecial, attempts to normalize the
symptoms may cause people to put off seeking help until the person with dementia’s condition has deteriorated beyond
the point where the family is able to cope and provide adequate care.
Continued on page 22
Anthropology & Aging Quarterly 2012: 33 (1) 15
Conference Report: 2009 Meeting of the American Anthropological Association
Session on Culture, Health and Aging in Native North American Communities
Perspectives on Brain Autopsy, Diabetic Amputation, and End-of-Life Issues among Elderly American
Indian People
Neil Henderson, Health Promotion Sciences, University of Oklahoma Health Sciences Center, L. Carson Henderson, Health Promotion
Sciences, University of Oklahoma Health Sciences Center, Ryan Blanton, Anthropology, University of Oklahoma and
Steven Gomez, Anthropology, University of Oklahoma
The American Indian (AI) population is rapidly aging and, consequently, at increased risk for dementing diseases like
Alzheimer’s disease and other dementias (AD/RD). While the exact epidemiology of AD/RD among AI people is unknown,
current research shows that AD/RD is certainly present among North American indigenous people. The net result is that
more cases of AD/RD will increase among AI’s due to more people living into the ages of greatest risk. Moreover, there is
an association between AD/RD and diabetes which remains at epidemic proportions among AI’s.
AD/RD are fatal diseases and/or contribute to mortality. Unfortunately, very little is known about contemporary AI beliefs
and practices regarding end-of-life (EOL) phenomena in general. Even less is known about EOL in relationship to death caused
by dementia. This gap is important because 1) caregiving and coping are stressful and benet from appropriate information
and counseling, and 2) neuroscience efforts to ameliorate AD/RD require post-mortem brain tissue for pathophysiologic
process examination and denitive diagnosis. However, a common cultural principle demands that bodies be buried intact
which, in turn, reduces post-mortem opportunities for AI-specic research.
Cultural Context Of Post-Mortem Body Alteration
Among many AI’s there is a belief that the body should be physically whole at burial. “Physically whole” means without
loss of body parts from amputations, other surgical interventions, or retention of body parts at autopsy. The overarching
reason for this belief is that in the after-life, the person will need all body parts in order to be as functional as they were in life.
The implied concept is that in some way, the death of the person who has had pre- or post-mortem body part loss will be
hampered in their ability to travel the spiritual path to the after-life. Stated more emically, the concept is that all body parts
are required for full spiritual coherence, peace, and function in the after-life.
Clearly, the value placed on body intactness at burial is a signicant one of long-standing history. Surgical resection of
diseased body parts, particularly for life-saving purposes, is commonly accepted by AI people. Surgical amputations of
limbs and digits to prevent general sepsis beyond the local dead tissue are also unfortunately common. For many people,
these surgical procedures evoke a conict of belief and practice even if they are not always voiced. However, because
autopsy, of course, does not save the autopsied person’s life, it still is subject to the intact body value referred to above.
Methodology
The research design is from the interpretivist paradigm using grounded theory. The theoretical wellsprings include David
Mechanic’s Health Belief Model, Help-Seeking Behavior and Arthur Kleinman’s Explanatory Model of disease. Data was
collected by a one-time, 45-minute, semi-structured interview with AD/RD caregivers in ve Federally recognized Oklahoma
AI Nations (n=77). There was an assessment of the Degree of Cultural Identication (DCI) using a 20 item questionnaire.
Findings
There is a range of willingness to have post-mortem brain autopsies. The range is a function of age and degree of tribal
cultural identication. For example, the post-mortem intact body preservation value is strong among those with age
above 60 and high DCI loading. However, for those younger and with low DCI loading, the value is weak. There is also
a “Conditional Belief-Flexibility” in which post-mortem brain autopsy is potentially acceptable if, there would be a small
amount of brain tissue removed, there were a way to non-intrusively extract brain tissue (e.g., nose, mouth, eye orbit, ear
canal), the brain tissue was examined and returned for burial, or medical progress was an outcome. This “Conditional Belief-
Flexibility” position may represent a conceptual adaptation between contemporary sociocultural conditions abutting older
more non-Western cultural systems. Such an interpretation may also help explain that post-mortem brain autopsy was often
reconceptualized as similar to the more generally familiar “organ donation” concept which is commonly noted on driver’s
licenses.
Continued on page 21
Anthropology & Aging Quarterly 2012: 33 (1) 16
Conference Report: 2009 Meeting of the American Anthropological Association
Session on Culture, Health and Aging in Native North American Communities
Discussion
Robert C. Harman, Professor Emeritus, Cal State, Long Beach and Wayne Warry, McMaster University.
We conclude by noting some general comments on the papers and presentations. As most of the papers are coauthored, for
simplicity’s sake we refer to the papers by the rst author or presenter’s name.
The papers submitted are based on recent, qualitative and in some cases ongoing research among Aboriginal/Native
American peoples of Canada and the United States. All the papers differ somewhat in methods and interpretive orientations.
Jervis’s and Abonyi’s papers most explicitly address the cultural ideal of the preeminence of Elder’s status or role within
Aboriginal cultures; but several of the papers speak to the changing perceptions and roles of Elders, and of course, cite
idealized conceptions of health and appropriate behavior that cannot or are sometimes not met by others. Abonyi and
Jervis’s papers concern more general aspects of aging and qualities of health and care. In contrast Jacklin, Pace and
Henderson’s papers address aspects of dementia or end of life health within the cultural and social context of Aboriginal
health and illness.
Each of the four papers has somewhat different objectives and data. Abonyi’s paper is a biographical account of Maria’s
life that reects on traditional ways and changes affecting the lives of older Aboriginal peoples. The research highlights
beliefs about healthy aging which are linked to notions of community, community involvement and engagement. That is,
the analysis suggests that health is produced not simply by individual action, but through socially constructed behaviors
and interactions. Jervis analyzes Respect as an American Aboriginal concept, specically as it applies to the social and
cultural status of Elders. Her analysis shows the linguistic complexity of the concept “Respect,” as it pertains to elders.
Jervis’s paper also addresses changes in Aboriginal society and culture. Professor Harman notes at one point Jervis found
that some, perhaps most, Aboriginal families want to enjoy the presence of older relatives and provide them with care.
Harman says he believes that “Implicit conventional understandings and generous care giving, smack of what Westerners
call unconditional love.”
Jacklin’s analysis in two cultural and geographic areas of Ontario emphasizes attitudes toward Alzheimer’s disease from
both traditional Aboriginal and Western Perspectives. She develops explanatory models of diagnosis and treatment that
contrast traditional Aboriginal and biomedical understandings. Her analysis makes the important point that language
and ceremonial participation with the requisite knowledge of traditional teachings and values are integral to good health.
That implies healthy living, cognitive health, and developing meaningful systems of care. Pace is primarily concerned with
cognitive aspects of Aboriginal health and aging and with cultural constructions of healthy aging. Henderson’s research
focuses on beliefs and behaviors around end of life and medical interventions that necessitate bodily interventions or
transformations of the “whole“ body and thus clash with traditional beliefs.
The common threads that seem to run through these research projects are that of changing or contested values and beliefs
which come with what Henderson calls degrees of cultural identication and which other authors refer to as traditional or
cultural orientation. The ip side of such analytic focus is the extent to which biomedicine, and the values represented by
the dominant medical system, have been accepted by individuals and communities. The papers quite naturally analyze
the nature of changing systems of care, emerging values around health and aging, and the diversity of behaviors that arise
from the interaction of Western and Indigenous values and health beliefs. The tension between cultural identication and
biomedical values or power are manifested in many ways throughout the papers, for example, in how Abonyi refers to
Aboriginal Peoples relying less than other segments of the population on formal care
continued on page 20
Anthropology & Aging Quarterly 2012: 33 (1) 17
AAGE activities
Jay Sokolovsky
Professor and Chair, Dept of Society, Culture and Language
University of South Florida, St. Petersburg
I just wanted to offer a follow-up after the AAA meetings.
I just received a list of members and we have 575 who are
signed up! Perhaps it is even time to think of forming a
AAA unit. As you might have noticed from the program
there continues to be a strong showing of sessions and
papers in this area. There also was a continuation of
strong participation of scholars from Europe in these
sessions and the promise of continuing cross-national
collaboration. Our sponsored interlocutor session
involving two anthropologists working within Intel
Corporation on technology and late life drew strong
attention and will likely form the basis of a new book on
the “Digital Life Course” in the Berghahn Series on Aging
and the Life Course (hint, I am still looking for future
manuscripts).
There was also some discussion of the following issues:
Facebook page – thanks to Sari Hale – Alper there is now
an Anthropology&Gerontology web book page (http://
www.facebook.com/groups/125155407560016/). This will
be a good place to plan sessions for the 2012 AAA in San
Francisco.
SFAA 2012 (Baltimore March 27-31) has a number of
sessions on aging and the life course and Maria Vesperi
and I have organized a Saturday morning Breakfast
Workshop – co-sponsored by the Interest Group and
AAGE. Please let me know if you will be in attendance at
SFAA:
Maria Vesperi and Jay Sokolovsky – “Innovative
Approaches to Teaching about Aging and the Life
Course”
Samantha Solimeo - “Public Sector Anthropology of
Late Life”
Phil Stafford – “Nurturing Age-Friendly and Life-span
communities”
Sherri Briller & Janelle Christensen – “Crafting an
Anthropology Career in Aging and Life Course
Studies”
Maria Cattell – “Aging and Life Course Research in
Non-Western Cultures”
At the meetings there was active discussion of the
interest group seeking to become an AAA unit with low
dues, such as $10. Such a unit would not compete but
complement AAGE which would keep its journal AAQ
(see below). I would like your thoughts on this.
We need to start planning for the 2012 AAA meetings in
San Francisco – please let me know about any sessions you
are planning and especially any ideas for another special
event like the ones we had during the past two meetings.
You can listen to our event with Anne Basting at http://
blog.aaanet.org/2011/10/31/interview-with-anne-
basting/
Participation in the 2013 IUAES meetings; the 17th World
Congress of the International Union of Anthropological
and Ethnological Sciences, which has the overall theme
“Evolving Humanity, Emerging Worlds.” The congress
will be held in the city of Manchester, United Kingdom,
from Monday, August 5 to Saturday, August 10, 2013. See
http://www.iuaes2013.org/
Maria Cattell mgcattell@aol.com and Leng Leng Thang
lengthang@nus.edu.sg are the main organizers for the
IUAES Commission on Aging and the Aged. See the
attached le for more information. You should send
session ideas to them as soon as possible:
Sessions being developed:
Phil Stafford: Age Friendly communities: two tracks
A. Age-friendly Communities: Research Track
Seeks papers describing research into the social, health
and/or economic impact of efforts to create age-
friendly communities, both rural and urban.
B. Age-friendly Communities: Practice Track
Seeks papers describing culturally diverse methods,
practices, designs and organization of age-friendly
community development initiatives.
staffor@indiana.edu
Jay Sokolovsky (jsokolov@mail.usf.edu) and Maria
Cattell (mgcattell@aol.com) – Globalization and the
Life Course
Anthropology & Aging Quarterly 2012: 33 (1) 18
Book Reviews
McLean, Athena. The Person in
Dementia: A Study of Nursing Home
Care in the U.S. Peterborough, Ont:
Broadview Press. 2007. ISBN – 13:
978-1-55111-606-8. 312 pp., $27.95
(USD and CAD)
Using the comparative method,
Athena McLean beautifully illustrates
the sharp contrasts between two
distinct models of “care” for
cognitively-impaired adults in a
large, multi-unit nursing home on
the eastern U.S. coast. In this book
– which won the New Millenium
Book Award from the Society for
Medical Anthropology – McLean uses
ethnographic techniques, case studies,
and robust theoretical and historical
framing to describe and explain
the care philosophies and practices
employed in the two nursing home
units she studied. One of the units
is characterized by a regimented,
task-oriented approach to elder care
that ignores the resident’s remaining
cognitive and relational abilities. In
the other unit, a holistic, person-
centered approach is in place in
which attention is paid to resident
needs, desires, and overall well-being.
McLean successfully demonstrates the
success of the person-centered care
model in terms of resident outcomes,
as well as employee and family
satisfaction.
The six case studies focus on
the resident-staff microcosm as a
way to explore personhood and
illustrate differences in nursing
home unit culture. McLean identies
and explains key unit differences
as a function of the autonomy,
background and approach of each
unit’s head nurse. The unit of
analysis, the resident-staff dyad,
frames the presentation of the data to
capture her theoretical and empirical
interests with precision.
Readers from many walks of life
will nd this book compelling.
Some chapters will appeal to social
scientists and gerontologists, while
others will attract health care and
aging professionals and/or those
interested generally in the elderly in
American culture. In many ways,
this book is a work advocating for
solutions to the deciencies in the
long term care system in the U.S.
Indeed, the book’s strong conclusion
about respect for the whole person
recommends a particular path for
dementia care in the future.
As someone with a new and growing
interest in long term care, but engaged
in organizational issues throughout
my career, this book prompted me
to think about alternate ways of
exploring the culture of McLean’s
eld setting. I believe that her priority
and focus on particular roles (e.g.,
nursing home resident and caregiving
staff) could be enhanced and
extended by researchers who bring
an organizational-culture lens and an
applied orientation to long-term care
organizations. This dual emphasis
might include an analysis of roles, but
would likely explore roles in relation
to organizational relationships,
strategies, and functioning. For
example, I kept wondering why
the two systems of care co-existed,
why there was little to no transfer of
knowledge or personnel across the
two units, and whether the presumed
efciencies of the regimented, task-
oriented approach collided with the
described superiority of the person-
centered approach.
McLean is clearly interested in policy
– changing the way older persons
with dementia are treated. She offers
a whole section of recommendations
for change. Yet the absence of an
organizational research component
and an approach to organizational
change diminishes, to a certain
extent, the effectiveness and
practicality of her recommendations.
An organizational research design
ideally would have included an
examination of the larger nursing
home administrative structure,
ideology, and behavior. That vantage
point would have illuminated the
cultural patterns, skillfully described
by McLean, within the context of
rules and resources available to
the larger organizational entity.
Organizational researchers would
have focused on those factors that
allowed the variation in unit care
to continue, thereby shedding light
on broader nursing home goals,
decision making, and internal conict.
Moreover, the metrics used to
evaluate the performance of all roles
within the nursing home hierarchy –
including those in the management
chain – would have been gathered to
compare unit behavior with overall
organizational expectations and
effectiveness. In McLean’s study,
nursing home management appears
not to have been actively involved
in the study or in its output. An
ability to fully learn from the two-unit
comparison, and innovate based on
the results, seem to have been lost.
These criticisms are actually
compliments to the author. She has
powerfully shown how the culture
of nursing homes and the treatment
of older adults with dementia need
to change. Her important, insightful,
and well-written book is a call to
action – but that action may in part
require a different approach and
orientation for the anthropologist or
gerontologist, not just the nursing
home.
Elizabeth K. Briody, Ph.D.
Founder and Principal
Cultural Keys LLC
Anthropology & Aging Quarterly 2012: 33 (1) 19
Book Reviews
Jacoby, Michael. Ten More Good
Years. New York, NY: Look Out
Films, 2008. 71 min. $15.95 (home
version) $195 (Institution with
educator guide), $75 (Community
groups and non-prot organizations
with educator guide)
“I’d like to know would you really
like to show me where you live, I’d
like to know were you really ever
there and when it all goes down I
hope you’ll still be there.”
These lyrics from the opening song
in ten more good years, performed by
Sorenson & Mechlowicz, speak to the
often misunderstood experiences of
gay elders in America—a segment of
our population whom social science
scholars often call “invisible”.
In this documentary, Michael Jacoby
presents views of growing old in the
gay community through ethnographic
interviews with four LGBT (lesbian,
gay, bisexual, transgender) elders.
Why does the aging experience of
gays merit an in-depth look? In his
article, Honoring our Pioneers, Jacoby
relates that in his younger years,
after forming a friendship with an
elder gay man he learned about the
plight of “a whole generation of men
and women out there who had been
left behind and forgotten . . . . They
came out of the closet at a time when
they could lose their jobs, family,
and friends and even get arrested
for doing so. They are the men and
women who survived the AIDS crisis,
battled government, and built LGBT-
friendly communities in major cities
across America . . . . It boggled my
mind that so many of our heroes were
facing such an onslaught of so many
unfair circumstances with so little
support and so few resources to turn
to” (The Advocate, Sept. 12, 2009).
Contemporaneously incorporating
some of the commonalities and
challenges of aging experiences in
America, the lm also explores some
important particular realities of aging
for gay elders. Jacoby presents a
tapestry of personal stories, media
clips, and factual data with an
interweaving of expert testimony and
commentary from what he offers as a
series of reputable sources. Included
are representatives of SAGE, NY
(Service and Advocacy for GLBT
Elders); New Leaf Services, San
Francisco; The Task Force, NY; Brian
deVries, PhD, Director of Gerontology
at San Francisco State University;
NCLR, San Francisco, (National
Center for Lesbian Rights); and
the NY Chapter of NOW (National
Organization of Women), among
others. Commentaries by these
experts highlight numerous injustices
facing members of the gay community
as they traverse the unknown terrain
of growing old, shedding light on
some unique challenges facing
gay elders. Terry Kaebler (SAGE)
explains why aging experiences
can be different and present some
particular challenges for those in the
gay community. These challenges
include an erroneous assumption by
some care providers that all elderly
are straight. This scenario can lead
to difculties or even an inability for
some gay elders to access programs
and services. Other evidence shows
how social service agencies, even
those which receive federal dollars for
senior services, too frequently indicate
that “they are not accepting of gay
elders.” Jacoby’s sensitive exploration
into the lived experiences of gay
elders often speaks to the loneliness,
isolation, and many losses—of life
partners, nancial security, health,
and housing. He documents how
some gay seniors, who were at the
forefront of the Gay Rights Movement
in the 1970s, now nd themselves,
in their “golden years” returning to
the closet—to secure housing, access
community resources, and nd
acceptance.
This lm reveals a compelling truth:
despite these harsh realities of what
it means to be gay and old, there is
often resilience among gay elders,
an understanding of what it means
to be different. A common thread
among those interviewed is one that
conrms, “we will take care of our
own.” Jacoby’s portrayal of being
old and gay demonstrates their
determination, survival, and pride
in identity—giving voice to an often-
overlooked segment of the American
population.
A strength of ten more good years is
its inclusion of personal life stories
of gay elders and testimony by
gerontologists and LGBT experts.
A weakness is its primary focus
on aging gay males’ experiences,
too often “hiding” aging lesbians’
experiences and perspectives. A
more accurate portrayal of the lived
experience of gay American elders
would also have more diversity
represented in terms of socioeconomic
differences, rural vs. urban
experiences and so forth.
As a gerontologist, novice
anthropologist, and member of the
aging gay community, Jacobys’ lm
opens the dialogue for continued
exploration into what it means to
age in America, and what it means
to be human. This is an important
lm for anyone interested in LGBT,
gender, and aging studies. ten more
good years raises societal awareness,
answers questions, and calls for
programs and services that are
sensitive to the needs of all elders,
including those within the gay
community.
Terri Ann Liller, MBA, PhD Student
Department of Anthropology
Wayne State University
Anthropology & Aging Quarterly 2012: 33 (1) 20
important part of the cultural renewal process taking place for many years now among Aboriginal people in Canada.
The importance of retaining aging seniors in communities and supporting their aging well in place requires us to
consider, for example, the nature and value of community- and kin-based informal care systems in Aboriginal contexts.
This one example highlights that there are substantive and meaningful differences in the aging experiences of Aboriginal
and non-Aboriginal seniors. It is timely that we now turn in Canada to the inclusion of Aboriginal ideas about aging
in frameworks applied to Aboriginal contexts. In collecting more stories about aging well, we will ask, “what does
aging well mean to you?” The answers to this question may allow us to be better positioned collectively to navigate the
interface between western and other contexts in the design of effective policies, programs, and support for the growing
cohort of aging Aboriginal seniors in Canada.
* The term Aboriginal refers to the descendants of the original inhabitants of Canada, as dened by the Constitution Act
1982; Indians, Inuit and Métis.
References
Collings , P. (2001). “If you got everything, it’s good enough”: Perspectives on successful aging in a Canadian Inuit
community. Journal of Cross-Cultural Gerontology 16(2):127 –155.
Edge , L. , & McCallum , T. ( 2006 ). Métis identity: Sharing traditional knowledge and healing practices at Métis elders’
gatherings. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 4(2):83 –115.
Abonyi, continued from page 11
Jervis and Warry continued from page 12
Acknowledgements
We wish to express our appreciation to our research participants and collaborating tribes and host organizers
References
Dillon, R. S. (1992). Respect and care: Toward moral integration. Canadian Journal of Philosophy, 22(1), 105-132.
Weibel-Orlando, J. (1989). Elders and elderlies: Well-being in Indian old age. American Indian Culture and Research
Journal, 13(3 & 4), 149-170.
Harman and Warry continued from page 16
and more on the informal sector, especially within their large tended family networks and in Jacklin’s observations about
negative perceptions of Nursing homes and a preference for family care giving for elders with memory loss.
Whether these ideological tensions are framed in terms of older notions of resistance, cultural resiliency or more contemporary
notions of post colonialism or hybridity anthropologists are confronted with the analytic challenge of teasing out the nature
of contemporary Aboriginal health beliefs and behaviors that are the product of culture change and the contestation of beliefs
that ultimately shape peoples pursuit of health, their desire for appropriate care, and their experience of illness and disease.
Collectively these papers exemplify anthropologists’ desire to ensure the best of biomedicine, while identifying the hazards
potentially dangerous aspects of mainstream medical care in the Aboriginal cultural context. The papers advocate on behalf
of safe and effective care for aged Aboriginal peoples. Agencies that provide health care for Aboriginal communities must
become better informed about the cultural orientations of those Aboriginal individuals and communities they serve. More
collaboration by mainstream health care personnel with anthropologists will help to ensure that Aboriginal beliefs and
values are honored by Western practitioners.
identifying the hazards potentially dangerous aspects of mainstream medical care in the Aboriginal cultural context. The
papers advocate on behalf of safe and effective care for aged Aboriginal peoples. Agencies that provide health care for
Aboriginal communities must become better informed about the cultural orientations of those Aboriginal individuals and
communities they serve. More collaboration by mainstream health care personnel with anthropologists will help to ensure
that Aboriginal beliefs and values are honored by Western practitioners.
Anthropology & Aging Quarterly 2012: 33 (1) 21
Henderson, Henderson and Gomez, continued from p.15
grief and historical trauma, stress, alcohol and drug abuse; and (3) Indigenous -- Disruptions in the relationship to the
land and traditional life ways and bear-walking (we understand bear-walking to refer to a form of ‘bad medicine’ that is
directed towards an individual). We have found the relative proportion of people placing importance on physiological
explanations of causation to be much greater at Six Nations suggesting that in a relatively short period of time a
medicalized explanatory model of causation has emerged for participants at Six Nations. This is likely related to the
availability and accessibility of western health care services. In contrast, the communities on Manitoulin Island appear
to still be in a period of explanatory model negotiation. The tendency has been for respondents to look at the onset of
dementia as a natural part of aging or to engage in a discourse of social dis-ease; for example, failure and suspicion
of the medical systems especially in relation to prescription medications, Indigenous beliefs about balance, historical
trauma, and bear walking. Very few people recognized this as a genetic disease, vascular disease or a brain disease. We
feel comfortable in saying that at this time ADRD has not been medicalized for the First Nations on Manitoulin Island.
Conclusion
In the case of new illnesses explanatory models and specically those around causation serve to highlight cultural
dis-ease as it is related to the struggle between biomedical and traditional approaches to aging and health and
much broader socio-political struggles to protect Indigenous epistemologies under the pressures of colonial and
post-colonial states. The process of medicalization we see in relation to dementia provides us with an opportunity to
examine the relationship between the colonial system of biomedicine and modern indigenous communities; and, the
struggle to negotiate models of understanding that incorporate traditional values and understandings with biomedical
explanations. This site-specic depth of understanding will allow for knowledge translation activities that are sensitive
to the specic needs and beliefs of these diverse communities.
While the sites differ in their level of adoption of biomedical ideas of causation of dementia we see at both locations a
model emerging that places value and emphasis on traditional values, cultural attributes, and traditional methods of
prevention and healings in the prevention and care of individuals with memory loss and confusion. This represents a
strong assertion of the place of Indigenous health in an increasingly medicalized domain.
Acknowledgements
We express our gratitude to our research partners Six Nations Health Centre, Noojmowin Teg Health Centre,
Mnaamodzawin Health Centre, and Nahndahweh-Tecigehgamig Wikwemikong Health Centre; the participating First
Nations: Six Nations, Wikwemikong Unceded Indian Reserve, Zhiibaahaasing, Sheshegwaning, M’Chigeeng, Aundeck-
Omni-Kaning, Whitesh River, and Sheguiandah; research assistants Karen Pitawanakwat, Jessica Pace, Trisha
MacDonald and Lisa Boesch; and research coordinator Agnes Kanasawe. Our research is funded by the Alzheimer’s
Society Canada and the Ontario Mental Health Foundation.
Jacklin and Warry, continued from page 13
In summary, a post-mortem intact body preservation value exists as a strongly positive relationship among those with high
age and DCI loading whereas it is an inverse relationship among those with low age and DCI loading. Essentially, those
older, more “traditional” people were more likely to reject brain autopsy and those less traditional and younger were more
likely to accept it. Those with the Conditional Belief-Flexibility” position that made brain autopsy potentially acceptable was
characterized by two positions: 1) if changes to the medical protocol could be made that honored the value, then it could be
more acceptable, and 2) if there is general social benet, then it could be more acceptable. To the extent that AI’s may have
some unique characteristics due to the indigenous origins compared to the majority population, participation in medical
research could generate signicant insights that could assist with the development of better understandings and treatments
for all people. Consequently, there is a signicant need to better understand EOL sociocultural phenomena so that at least a
chance for negotiation of AI models and biomedical models can be tried.
Acknowledgements
Funding for this study was provided by the Centers for Disease Control and the Alzheimer’s Association.
Anthropology & Aging Quarterly 2012: 33 (1) 22
This can lead to increased caregiver burden and can also raise the level of stress faced by the person experiencing
symptoms. Further, poor understanding of the condition, what causes it, and how to manage symptoms may increase
the risk for shame and stigma. Knowledge about how to support a person with dementia, and available medical
interventions are low. Culturally-appropriate educational materials and increased health promotion would be of value
to the seniors and families in these communities. In particular, education about when, where and how to get help for
dementia is needed.
It is inherently difcult for people with dementia to meet the criteria for successful aging. Fear about their condition or
stigma related to mental health often cause people to withdrawal from social activities, and the symptoms of dementia
can make it difcult for individuals to participate in activities and interests in the way they were able to before the onset
of the condition. If people with dementia withdrawal and isolate themselves, or are isolated by family members out of
embarrassment or shame, the problem becomes invisible to the community, and potentially to healthcare providers.
This can be a barrier to both care provision and awareness. However, cultural perceptions of aging and what it means
to age successfully can be used to positively impact the lives of people experiencing dementia. The value of maintaining
a purpose in life and an active engagement with the intellectual, spiritual, emotional and physical realms is particularly
relevant in the context of promoting personhood and the continued integration of persons with dementia in community
activities. If we can determine what ‘purpose’ elders in contemporary Aboriginal communities want to have we can
better assist people with dementia to achieve value in their lives in a way that has meaning to them thus, allowing for
the promotion of better quality of life. With adequate support from family, friends and health care providers many
elements of successful aging can be approached, if not achieved, for people with dementia. However, in today’s
changing world, the challenge is to continue to keep families engaged in the care and support of seniors with dementia,
which can be difcult when adult children work or move away from the reserve.
Conclusion
Aboriginal peoples on Manitoulin Island hold values that are generally supportive of seniors and that promote healthy
and active aging, even in the face of complex health concerns. However, the care needs of seniors with dementia are
complex and demanding and the lack of access to information, services and culturally-appropriate supports put a great
deal of pressure on individuals with ADRD as well as family caregivers. In a discourse about acceptance and respect
there is denial and a lack of knowledge about the realities of the needs of people and families coping with dementia. This
lack of awareness of dementia can lead to inherently disrespectful actions which can compromise the dignity and safety
of elders with dementia. It is necessary to better promote culturally safe knowledge, education and training related to
this condition for seniors, families and care providers and to work with the cultural values of purpose, acceptance and
respect to promote better health and quality of life for Aboriginal people dealing with dementia.
Acknowledgments: Sincere thanks to all of the individuals and organizations on Manitoulin Island who lent their
time and expertise to this research project. Special thanks to Mnaamodzawin Health Services, Noojmowin-Teg Health
Services and the Wikwemikong Health Centre. I would also like to express thanks to my research assistant, Karen
Pitawanakwat, for her hard work and dedication, and to the Principle Investigators of the project, Dr. Wayne Warry
and Dr. Kristen Jacklin. This research was supported by the School of Graduate Studies at McMaster University, the
Indigenous Health Research Development Program, Ontario Mental Health Foundation and the Alzheimer’s Society of
Canada.
Pace continued from page 14
Anthropology & Aging Quarterly 2012: 33 (1) 23
AAGE Member News
Congratulations to Maria Cattell, PhD, outgoing President of the
Association for Africanist Anthropology (AFAA), a section of AAA. Maria
presented the AFAA Distinguished Lecture, “Gender, Generation, and Time
in Sub-Saharan Africa,” at the recent AAA meetings in Montreal. In her talk,
Maria explored the changing dynamics of gender and generation in the context
of transformations in African societies over the past century, with a focus on
shifts in intergenerational relations in such everyday practices as kinship and
reciprocity, conict, and the uses of tradition.
Meet the New Editorial Board
The editorial board of the AAQ is essential to dening who we are and the work that we do. Bringing
in more board members not only opens more doors for nding the very best scholarly content, but it
reinforces our commitment to recognizing and cultivating the diversity and depth of our eld. Of the
current thirteen indiviuals on the editorial board, ve are new this year. Over the next three issues I will
introduce them all and extend my own appreciation for thier service to AAGE.
Judith Corr, Ph.D.
Department of Anthropology Grand Valley State University, Allendale, MI
Professor Corr is a primatologist, receiving her Ph.D. in Anthropology
From Ohio State University. Her research and publications are
unique not only because they have focused on social aging among
primates, but also because she has studied aging among both Rhesus
Macaques and chimpanzee populations. Her publications include
“Social Behavior Among Aged Rhesus Macaques,” (Collegium
Antropologicum, 2006), “Nuns and Monkeys: Investigating the
Behavior of our Oldest Old” (In, Science of Aging Knowledge
Environment, 2004), and “Comparative models of cognitive decline
in aging great apes” (in Aging in Nonhuman Primates, 2002)
Professor Corr’s expertise in Biological Anthropology is a rst step
in introducing a broader range of anthropological approaches and
research to AAQ and we are thrilled that she has agreed to sit on the
board.
Welcome to AAQ Judi!
Anthropology & Aging Quarterly 2012: 33 (1) 24
Meet the New Editorial Board
Jon F. Nussbaum
Communication Arts and Sciences & Human Development and Family Studies, Pennsylvania State
University, Philadelphia, PA
Professor Nussbaum has a vast amount of experience and a prolic publication record on issues
surrounding aging, communication and quality of life. This unique eld of research interests
highlights the anthropological concentration on
the everyday lived experiences and institutional
complexity of aging and the life course, and provides an
important link for this journal to related areas such as
human development, language, and healthcare policy.
Some of Professor Nussbaum’s recent publications that
peaked my interest include Communication and intimacy
in older adulthood (with Miller-Day and Fischer, 2009)
and “Ageism and ageist language across the life span:
Intimate relationships and non-intimate interactions”
(with Pitts, Humber, Krieger and Ohs, in Journal of Social
Issues, 2005). Over his career he has presented over 150
papers and served on over 120 dissertation committees
across numerous disciplines.
Welcome aboard Jon!
Congratulations to President-Elect of the
Association of Anthropology and Gerontology
Samantha Solimeo, PhD, MPH
CADRE, Iowa City VA Medical Center
Anthropology & Aging Quarterly 2012: 33 (1) 25
Call for Submissions: Special Issue: Aging in East Asia
Anthropology & Aging Quarterly
Deadline for submission: March 20, 2012
This issue will focus on research on aging in East Asia (North and South), with particular interest in
the everyday lived experiences that highlight the region’s cultural diversity and shared challenges.
We particularly encourage submissions that acknowledge and explore the inuence of transnational
movements of people, technologies, health practices and welfare policies that are creating new linkages
and relationships across East Asia and the world.
Topics might include:
The effects of the March 11, 2010 Tsunami on older Japanese adults
The immigration of geriatric health care workers in Asia
Integration of grassroots and local welfare systems for older adults into state policies
Changing understandings of “successful aging” with increasing longevity
Medical pluralism among older adults, including traditional medicine and treatments
Cultural inuence of intergenerational relationships and family dynamics on care systems
East Asian perspectives on end-of-life and death with dignity
Role of religious beliefs and practices for older adults
Nursing homes in Northeast and Southeast Asia
See the general submission page for details on submission process, or contact Jason Danely (Editor)
jdanely@ric.edu for further inquiries.
Anthropology & Aging Quarterly 2012: 33 (1) 26
Submission Process All manuscripts should be submitted electronically, via e-mail attachment. Anthropology
& Aging Quarterly accepts four types of submissions--Research Reports, Policy and News Reviews, Commentaries,
and Articles.
Research Reports are brief discussions of ongoing or recently completed study and should be no longer than
2,000 words. Policy and News Reviews are pieces which offer thoughtful and reective commentary on current
events or social policies pertaining to aging and culture. Commentaries provide authors with an opportunity
to discuss theoretical, ethical and other time-sensitive topical issues which do not lend themselves to a
full-length article. Policy Reviews or Commentaries may range from 1,000 to 4,500 words. Articles are peer-
reviewed and manuscript submissions should include the following: a cover page with the author’s full
name, afliation, mailing address, and manuscript title; a 200 word abstract; the text; references cited; and
tables or gures. Endnotes are permitted but should be used sparingly and with justication. Articles should
not exceed 6,500 words, including all materials.
Manuscript Submission All submissions should be submitted via e-mail to the Editor, Jason Danely
jdanely@ric.edu. Unsolicited Book Reviews are currently not accepted. If you are interested in authoring
a book review please contact the Book Reviews Editor, Dr. Sherylyn Briller, at the Department of
Anthropology, Wayne State University, Detroit, MI, 48202. All manuscripts should use the citation style
outlined by the American Anthropological Association, available online at: http://www.aaanet.org/pubs/
style_guide.pdf
Evaluation Manuscripts will be evaluated by the Editor and a combination of Editorial Board members
and peer referees. Every effort will be made to expedite the review process, but authors should anticipate a
waiting time of two to four months.
Anthropology & Aging Quarterly
The ofcial publication of the Association for Anthropology & Gerontology
Information and Submission Guidelines
Anthropology & Aging Quarterly is the ofcial publication of the Association for Anthropology &
Gerontology (AAGE). It is published quarterly (February, May, August, November) by (AAGE). AAGE
is a nonprot organization established in 1978 as a multidisciplinary group dedicated to the exploration
and understanding of aging within and across the diversity of human cultures. Our perspective is holistic,
comparative, and international. Our members come from a variety of academic and applied elds, including
the social and biological sciences, nursing, medicine, policy studies, social work, and service provision. We
provide a supportive environment for the professional growth of students and colleagues, contributing to a
greater understanding of the aging process and the lives of older persons across the globe.
Submission deadlines
30(2) March 20th, 2012
30 (3) June 15th, 2012
30 (4) September 15th, 2012
... The World Health Organization (2020) estimates 5-8% of the global population over 60 live with at least one form of dementia. In Canada, Alzheimer's and other dementias will 'increase by 4.2 times for First Nations and 3.3 times for Inuit between 2006 and 2031' (Jacklin & Warry, 2012;MacDonald et al., 2018). In Guatemala, Mexico, Peru and Bolivia, increased dementia and cognitive impairment rates occur in 51% of Indigenous individuals over 65 (Nitrini et al., 2020). ...
... The intergenerational impact of colonial policies (e.g. residential schools) augments the mistrust towards the non-Indigenous health care system and mainstream health care providers (Browne et al., 2014;Jacklin et al., 2015;Jacklin & Warry, 2012). ...
... While we acknowledge that not all 'Indigenous populations have experienced the same historical traumas' (Warren et al., 2015(Warren et al., , p. 1960, historical traumas may have contributed to increasing the odds of developing dementia in Indigenous communities both in Canada and internationally (Warren et al., 2015). In Canada, policies supporting and enforcing the relocation of settlements to reserves, the criminalization of Indigenous ceremonies and healing methods, the residential schools, the removal of Indigenous children from their homes and communities represent concrete instances of historical traumas affecting the health and quality of life of Indigenous populations (Jacklin et al., 2013;Jacklin & Warry, 2012;Martin, 2012;Martin et al., 2017). Historical traumas appear to induce a higher prevalence of PTSD in Indigenous populations, notably through the 'enforcement of the colonial policy of mandatory residential schools' (Jacklin et al., 2015, p. 107). ...
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Aims To appraise the empirical literature on the needs of Indigenous informal caregivers caring for people living with dementia in Indigenous communities. Design Whittemore and Knafl's updated approach to integrative reviews, PRISMA guidelines, and CASP checklists for narrative analysis were followed. Data sources A systematic search of published empirical literature from January 2010 to August 2020 was undertaken in six databases. Review methods Fifty-one studies met the research question and the inclusion criteria. Results Five themes describe the findings: Decolonizing Western perspectives on dementia, the centrality of cultural safety, caregivers’ experiences, pre-dementia community education and family and community-centred care emerged from the thematic analysis. Most of the studies used quantitative methodologies, and few studies were conducted using community-based approaches. Conclusion This review shows that Indigenous caregiving represents an emerging field in nursing and health sciences in a context of a global crisis. Researchers need to focus on Indigenous values and voices to adapt care and support informal caregivers. Our review emphasizes that working with Indigenous communities will likely translate into new care delivery models, policies and practices to support Indigenous informal caregivers and address the specific social determinants impacting caregivers’ roles and tasks. Impact This review highlights the necessity of having community and family-based discussions on enhancing the delivery of dementia care for Indigenous peoples in Canada and worldwide. Decolonizing Western perspectives of dementia translate into culturally safe approaches that aim to integrate Indigenous cultural perspectives of holism, reciprocity, wisdom, respect of older people and relationality into nursing practice. The support of Indigenous informal caregivers requires future studies to address the stigmatizing Western views of dementia.
... The studies and reports we reviewed that discussed dementia in an Indigenous framework included participants who described dementia as a "natural" part of the "circle of life." This was the case for the Secwepemc in British Columbia (Hulko et al., 2010), for communities in rural Northern Saskatchewan (Lanting et al., 2011), for multiple communities in Ontario (Jacklin & Warry, 2012;Pace, 2013), and Ojibwe in the United States (Boss et al., 1995). A study with Secwepemc communities in British Columbia found that community Elders 1 held differing perceptions of dementia and that these understandings have changed over time (Hulko et al., 2010). ...
... During a roundtable gathering in Ontario, Indigenous participants from on-and offreserve communities in Ontario described dementia as part of the natural life cycle and a return to the stage of infancy (Sutherland, 2007). The cultural understanding of dementia as "normal" and as part of "the circle of life" was consistent among diverse Indigenous communities in Ontario, including the Haudensaune people of Six Nations of the Grand River Territory in Southern Ontario, and the seven rural Ojibwa, Odawa, and Pottawatomi First Nations of Manitoulin Island in Northeastern Ontario (Jacklin & Warry, 2012;Pace, 2013). Arguably, the view of dementia as "normal" is widespread across many non-Western cultures (Botsford, Clarke, & Gibb, 2011); however, the nuances of how "normal" is defined and understood vary considerably. ...
... The most widely held view found to date is that dementia is a natural part of the life cycle. Yet, in most studies, the participants also held alternative views of dementia as a disease caused by external determinants such as Western foods, changes in lifestyle, drug and alcohol use, environmental toxins, and more (Butler et al., 2011;Hulko et al., 2010;Jacklin & Warry, 2012;Pace, 2013). One study in northern Minnesota linked dementia with lifestyle, suggesting "…what goes around comes around, and how we live our life will eventually come back to us" (Boss et al., 1995). ...
Article
RÉSUMÉ Les démences liées à l’âge constituent un problème de santé important au Canada, en particulier chez les communautés autochtones, où les taux de démences surpassent d’environ 34 % ceux retrouvés dans la population canadienne. Cette étude présente une synthèse des données qualitatives tirées des articles traitant de la compréhension culturelle des démences chez les peuples autochtones du Canada. Les résultats principaux suggèrent que peu de recherches ont été effectuées dans ce domaine, en particulier chez les Inuits et les Métis, malgré une progression de l’exploration de ce sujet au Canada. La synthèse de la littérature a révélé que la démence est perçue comme une partie naturelle du cycle de vie par de nombreux Autochtones. Bien que les modèles communautaires et informels de soins soulèvent d’importants défis pour les aidants naturels, ils sont régulièrement appliqués. Cette synthèse sera utile pour les organismes et les prestataires de soins de santé qui recherchent des approches appropriées pour répondre aux besoins des patients et des familles autochtones aux prises avec la démence.
... This finding is consistent with those of other scholars who have explored the impact of a Western diagnostic label on the interpretation of behavioral and personality changes, and the shift from traditional perspectives to biomedical ones. 31,[34][35][36][37][38] Previous research has also shown that interactions with clinicians, genetic counselors, and other service providers reinforce a biomedical framework around illness processes. 39 Given the interactions that members from this family group have had since 1998 with the clinical environment and genetic technologies, it is likely that these interactions have also contributed to the medicalization of EOFAD within this community. ...
... This is consistent with evidence that culturebeliefs around the role of family-helps indigenous groups to cope and care for those with dementia. 35,37 Thus, regardless of the impact that medicalization has had on knowledge and understanding, it has not had a similar transformative impact on approaches to wellness. This represents a strong assertion of the place of indigenous approaches to wellness in an increasingly medicalized domain. ...
... This represents a strong assertion of the place of indigenous approaches to wellness in an increasingly medicalized domain. 35,44 Nonetheless, we cannot underestimate the fact that there are other areas in which traditional approaches have eroded. The primary analysis and feedback from the Nation suggest that many fractures in intergenerational knowledge may be attributed to the displacement of children and youth to residential schools. ...
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Objectives: In 2007, a novel pathogenic genetic mutation associated with early onset familial Alzheimer disease was identified in a large First Nation family living in communities across British Columbia, Canada. Building on a community-based participatory study with members of the Nation, we sought to explore the impact and interplay of medicalization with the Nation’s knowledge and approaches to wellness in relation to early onset familial Alzheimer disease. Methods: We performed a secondary content analysis of focus group discussions and interviews with 48 members of the Nation between 2012 and 2013. The analysis focused specifically on geneticization, medicalization, and traditional knowledge of early onset familial Alzheimer disease, as these themes were prominent in the primary analysis. Results: We found that while biomedical explanations of disease permeate the knowledge and understanding of early onset familial Alzheimer disease, traditional concepts about wellness are upheld simultaneously. Conclusion: The analysis brings the theoretical framework of “two-eyed seeing” to the case of early onset familial Alzheimer disease for which the contributions of different ways of knowing are embraced, and in which traditional and western ways complement each other on the path of maintaining wellness in the face of progressive neurologic disease.
... The close relationships with family and friends and the larger sociocultural contexts (such as values, norms, and beliefs) have often been ignored (Antelius & Plejert, 2015). Although some improvements have occurred during the last 10-15 years (especially by Cohen, 1995Cohen, , 1998Henderson, 2002;Henderson & Henderson, 2002;Henderson & Traphagan, 2005;Jacklin & Warry, 2012; of as "extra vulnerable" having a dementia disease, which might cause them to not always remember what they have consented to or who the researcher is from one time to another, extra sensitivity is demanded on the researcher to be able to "read" situations and voluntarily withdraw if one suspects that the participant is not comfortable with the situation. Also, all legal guardians (in Swedish, god man) as well as relatives were asked to consent. ...
In quite a short amount of time, Sweden has gone from being a relatively homogeneous society to a multicultural one, with a rapid expansion of immigrants having culturally and linguistically diverse (CALD) backgrounds growing old in Sweden. This is particularly interesting in relation to studying age-related dementia diseases. Research shows that not only do CALD persons with dementia diseases tend to mix languages, have difficulties with separation of languages, or revert to speaking only their native tongue as the disease progresses, but they also show tendencies to experience that they live in the cultural environment in which they were brought up, rather than in the current Swedish one. In this article, we explore findings in relation to one such CALD group in Sweden, Iranians. The article is empirically driven and based on data gathered in 2 separate settings with specific ethnocultural profiles, offering dementia care with Middle Eastern, Arab, and/or Persian profile. Observations were carried out in combination with semistructured in-depth interviews (n = 66). By using a combination of content and ethnographic analysis, 4 main findings related to ethnocultural dementia care were elucidated. These include (a) a wider recognition of people from different CALD backgrounds possibly having different perceptions of what dementia is, (b) a possibility that such ascribed meaning of dementia has a bearing on health maintenance and health-seeking behavior as well as the inclination to use formal services or not, (c) choosing to use formal service in the forms of ethnoculturally profiled dementia care facility seems to relate to being able to “live up to ideals of Iranian culture,” and (d) “culture,” however ambiguous and hotly debated a concept it is, appears to be a relevant aspect of people's lives, an aspect that is both acquired as well as ascribed to oneself and to others. As such, we argue that culture needs to be further addressed in relation to dementia care in multicultural societies because ascribing culture boxes people in as well as out. In addition, ethnocultural contextualization of dementia care needs to be understood in relation to this because it affects the care provided.
Chapter
Improving dementia knowledge and support among Canada’s Indigenous communities faces a host of intertwined ethical, epistemic, and logistical challenges. These challenges include distrust among Indigenous people of mainstream health care owing to traumatic colonial histories and ongoing social marginalization, as well as a lack of culturally appropriate prevention and diagnosis protocols, and divergent Indigenous and mainstream explanations of dementia and its meaning in human life. This chapter examines these challenges in light of debates that concern intercultural training in nursing and other health-care contexts, the creation of culturally appropriate care, and the value of cultural safety as a critical concept for decolonizing health-care access.
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The adoption of a holistic and population health approach to Métis health encourages us to consider indicators other than physical health that may contribute to our health and wellness as Métis. This article represents an overview of a traditional knowledge project with Métis Elders from across Canada, initiated by the Métis Centre at the National Aboriginal Health Organization. It is a collaboration between a Métis researcher and one of the Métis Elders who participated in the national and regional Métis Elders’ Gatherings over a four-year period. Based upon a collaborative presentation at the 2006 Healing Our Spirit Worldwide conference, the authors present their experiences as participants in this unique initiative as shared by the group of Métis Elders, seniors and healers with whom they engaged. From the knowledge made available through this process, factors that contribute to Métis identity, health, healing and wellness are identified and further explored. The foundations for the article rest on the following themes identified by project participants: health and healing by Métis through listening to ancestral voices; a return to the Michif language; a greater awareness of the significance of the role of Métis women and family to the health of communities; a better understanding of the centrality of our relationship to the environment for individual and community health and wellness; and an awareness of historical, cultural and Aboriginal language perspectives for understanding traditional cultural practices and protocols. The Métis Elders’ Gatherings are a demonstration of how events can facilitate and foster the exchange and practice of traditional knowledge in a respectful and reciprocal manner. It was a clear outcome of the process to the participating Métis Elders, seniors and healers that this type of collaborative community-based research initiative contributes to the enhancement of their own health as Métis today and, therefore, in turn, will contribute to the health of future generations.
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Using a political ecology framework to explore the gendered nature of extended family support networks for the elderly, this article reveals the ways that older women and men negotiate their social and material worlds in the context of extreme ecological and economic conditions. The historical processes that shape the social and material worlds in which these elders move include development induced resettlement, postcolonial politics and economics, and catastrophic chronic illness and mortality of children. Drawing from ethnographic research from 1994 through 2008, the article explores how people living in economically and ecologically dire circumstances manage their social and material worlds to the best of their ability.
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Body-image research has focused on younger women and girls, and tended to ignore women in later life, although recent studies have called for more research into the body image of older women, particularly from a lifecourse perspective. The lifecourse perspective can address the complexity of body image by identifying personal and/or environmental factors that shape body image and the trajectories of body image across the lifecourse. Accordingly the purpose of the study reported in this paper was to explore older women's body image using a lifecourse perspective. We conducted individual interviews and follow-up focus groups with 13 women aged 60–69 years, all of them resident in a United States non-metropolitan county (its largest city having a population of 38,420) and having lived in the country for more than 30 years. The findings highlight the influence of inter-personal relationships (e.g. with a spouse or parent), the macro-environment (e.g. media or community attitudes) and key life events (e.g. physiological changes or educational experiences) that shaped body image at various life stages. In addition, the findings demonstrate that as women age, they de-prioritise appearance in favour of health or internal characteristics. Finally, the findings highlight the complexity of body image as a construct, which includes attitudes toward appearance, evaluations of health and physical ability, and assessments of appearance.
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In her provocative discussion of the challenge posed to the traditional impartialist, justice-focused conception of morality by the new-wave care perspective in ethics, Annette Baier calls for ‘a “marriage” of the old male and newly articulated female ... moral wisdom,’ to produce a new ‘cooperative’ moral theory that ‘harmonize[s] justice and care.’ I want in this paper to play matchmaker, proposing one possible conjugal bonding: a union of two apparently dissimilar modes of what Nel Noddings calls ‘meeting the other morally,’ a wedding of respect and care.
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This review shows that Hong Kong and Singapore face a distinct and serious challenge to old-age income security due to their mix of public pension provision and intergenerational family support. They are among the fastest ageing societies internationally and will be the oldest in Asia after Japan by 2030. Yet their public pensions remain weak. Defined contribution pensions, even for full-career workers, are projected to replace just 17% of net lifetime average earnings in Singapore and 41% in Hong Kong, compared to 70% across the OECD countries. Instead, older persons in Singapore and Hong Kong depend mainly on their adult children for income security in the form of co-residence and cash transfers. More than half of them live with adult children. In Singapore, more than two-thirds receive financial support from the younger generation, compared to just 5% on average in Europe. Current welfare theory would suggest that Singapore and Hong Kong portray an extreme variant of welfare regime where the state’s role is more limited than in the liberal regime and the family’s role more central than in the Southern European regime. The sustainability of current old-age income security arrangements is therefore particularly vulnerable to new social risks that threaten the stability of traditional family structures. Already co-residence and financial support from adult children are declining. A fuller assessment of the prospects for old-age income security must focus on the interaction of pension policy and family support for elderly persons in different gender and income groups.
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The ageing of populations has been a topic of discussion during the last few decades, but how is this subject represented in the media, and what images of old age are produced? In this article we present the results of a quantitative content analysis that investigates how the concept of population ageing has been represented in Swedish local and national daily news press between 1988 and 2009, and the old age positions that are offered in these representations. We also use discourse analysis in order to qualitatively examine the ways in which the concept of population ageing is articulated in these news press articles and the old age positions that are thereby constituted. The results show that the concept is constituted as a naturalised expert concept, and is primarily used in order to contextualise articles about future political and economical difficulties or even crises. By articulating population ageing with both political policies, political economy and older people’s (as a group) reported need for care and services, population ageing was constituted as a political economic concern rather than a problem for the aged individual.
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The Gray Panthers, formed in 1970, are an intergenerational social movement focused on peace, health care, housing, income adequacy, and social justice. Despite the loss of founder Maggie Kuhn in 1995, and a diminished membership since its peak in the 1980s, the Gray Panthers continue today. Key elements in this organizational success are their distinctive ideology and tactics. Here their concept of “the person” and their “outrageous” activist techniques are analyzed using published and archival Gray Panther materials and drawing on the author's involvement as active member during 1977–1978, 1980–1987, and 2004–2010, and his perspective as an anthropologist and historian.
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My Mother's Hip: Lessons from the World of Eldercare (Temple University Press, 2004) is based on both my mother's experiences in navigating the healthcare system after suffering a double hip fracture and mine as her principal caregiver. What happens when an anthropologist who studies global aging inadvertently falls into the role of caregiver? Much like a physician who finds himself in an exotic world when becoming a patient, the social scientist–caregiver immediately begins to deconstruct the systemic flaws from a professional perspective. My Mother's Hip opened the Pandora's box of how we care for an aging society in the context of a fragmented medical system. We who write such books see a glaring need to inform the public about critical medical issues that inevitably crop up in the course of eldercare. Parallel to the medical story is the story of how an author produces a trade book about a problematical topic and promotes it without alienating the popular audience.
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Retirement migrants in Spain claim a particular vision of time as finally “theirs.” It is a time for living in the present and contrasts with their previous time-bound working lives. This liminal temporality, which seems to diminish the significance of aging, is disrupted, however, by the high visibility of aging and death in such a community. Using an ethnographic approach, the article explores the societal and individual negotiation of retired migrants' arrivals and departures from the social scene as pertinent moments to interrogate these matters. These reveal that migrants' present-focused temporality is yet wholly informed by subtle awareness of future-time as “not there.”