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"I can manage": The measure and the...

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"I can manage": The measure and the meaning of daily life among the elderly of Washington Heights in New York City.

Record Type:	Electronic resources : Monograph/item
Title/Author:	"I can manage": The measure and the meaning of daily life among the elderly of Washington Heights in New York City./
Author:	Costley, Alex W.
Description:	311 p.
Notes:	Adviser: Lesley A. Sharp.
Contained By:	Dissertation Abstracts International68-11A.
Subject:	Anthropology, Cultural. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3290507
ISBN:	9780549338987

"I can manage": The measure and the meaning of daily life among the elderly of Washington Heights in New York City.
Costley, Alex W.

"I can manage": The measure and the meaning of daily life among the elderly of Washington Heights in New York City. - 311 p.

Adviser: Lesley A. Sharp.

Thesis (Ph.D.)--Columbia University, 2007.

Through the lives of 64 community-dwelling elders in New York City (ages 69 to 91, with a mean age of 79), ethnographic research methods were employed to critique systematic biases and simplistic notions of dependency that are codified in the tools for assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Drawing upon perspectives from critical medical anthropology and critical discourse analysis, this work argues that when discussing the ability to handle daily tasks individuals routinely make important distinctions between "needing help" and "having difficulty." They grapple with fragile family and social networks. They make daily negotiations over independence and the imprecise meanings of chronological age. They also resist the stigma of being seen as frail and disabled. I argue that standardized and quantitative approaches to functional assessment often obscure these important and meaningful narratives. With increasing numbers of older adults "aging in place" (i.e. staying in their own homes and apartments as they age) with low expectations for family support and high hopes for affordable home care, meaningful measures of functional ability are crucial for defining real "limitations" and true need. This work urges anthropologists to look beyond previously studied institutional locations (such as nursing homes, senior citizen centers, and retirement hotels) as sites of old-age communities, since these sites do not represent the places where the vast majority of older adults are "aging-in-place" in the U.S. today. Also, while medical anthropologists have criticized biomedicine for overly "medicalizing" the aging process, the majority of these men and women felt that their physicians were their primary means for obtaining home care. I examine the social context and implications of this belief. Finally, this work concludes with a systematic evaluation and critique of a two-year educational effort to increase physicians' knowledge and awareness of resiliency in old age, revealing some fundamental attitudes toward interdisciplinary practice and rigid definitions of medicine that challenge such efforts.

ISBN: 9780549338987Subjects--Topical Terms:

735016
Anthropology, Cultural.

"I can manage": The measure and the meaning of daily life among the elderly of Washington Heights in New York City.
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245 1 0 $a "I can manage": The measure and the meaning of daily life among the elderly of Washington Heights in New York City.
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500 $a Source: Dissertation Abstracts International, Volume: 68-11, Section: A, page: 4753.
502 $a Thesis (Ph.D.)--Columbia University, 2007.
520 $a Through the lives of 64 community-dwelling elders in New York City (ages 69 to 91, with a mean age of 79), ethnographic research methods were employed to critique systematic biases and simplistic notions of dependency that are codified in the tools for assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Drawing upon perspectives from critical medical anthropology and critical discourse analysis, this work argues that when discussing the ability to handle daily tasks individuals routinely make important distinctions between "needing help" and "having difficulty." They grapple with fragile family and social networks. They make daily negotiations over independence and the imprecise meanings of chronological age. They also resist the stigma of being seen as frail and disabled. I argue that standardized and quantitative approaches to functional assessment often obscure these important and meaningful narratives. With increasing numbers of older adults "aging in place" (i.e. staying in their own homes and apartments as they age) with low expectations for family support and high hopes for affordable home care, meaningful measures of functional ability are crucial for defining real "limitations" and true need. This work urges anthropologists to look beyond previously studied institutional locations (such as nursing homes, senior citizen centers, and retirement hotels) as sites of old-age communities, since these sites do not represent the places where the vast majority of older adults are "aging-in-place" in the U.S. today. Also, while medical anthropologists have criticized biomedicine for overly "medicalizing" the aging process, the majority of these men and women felt that their physicians were their primary means for obtaining home care. I examine the social context and implications of this belief. Finally, this work concludes with a systematic evaluation and critique of a two-year educational effort to increase physicians' knowledge and awareness of resiliency in old age, revealing some fundamental attitudes toward interdisciplinary practice and rigid definitions of medicine that challenge such efforts.
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