Paper short abstract:

The notion of ‘becoming somebody’ assumes a creative, socially-valued process. But what does it mean in reverse, when ‘somebody’ becomes ‘nobody’? The experience of unbecoming confronts people diagnosed with dementia, creating justifiable fears which play out differently in different places. My focus is the Australian aged care system, in particular residential care places to which people with dementia are consigned.

Paper long abstract:

The notion of ‘becoming somebody’ assumes a creative, socially-valued process. But what does it mean in reverse, when ‘somebody’ becomes ‘nobody’? The experience of unbecoming confronts people diagnosed with dementia, creating justifiable fears which play out differently in different places. My focus is the Australian aged care system, in particular residential care places to which people with dementia are consigned. In that system, what one person has described as our dementia prisons, neglect, which in turn legitimises chemical restraint, hastens unbecoming. The extent of this horror was revealed in the 2021 Royal Commission into Aged Care.

Fear of dementia is not about the unbecoming associated with death, physical disability, or even terminal illness. It confronts us with a very specific kind of unbecoming, an unravelling of being. Family are encouraged to see themselves as ‘losing’ their partner, parent or grandparent. The people for whom that person has been a somebody are confronted with a choice – to adapt to the changes dementia brings, or to turn away. Medical and health professionals assume family will not cope and may encourage them to turn away: let paid professionals take that person through their process of unbecoming. They do this within ‘residential aged care’, often a euphemism for abandonment.

Referring to Brazilians abandoned by family and society, Biehl (2012) points out that ‘the abandonment of unproductive and unwanted family members is facilitated and legitimated by drugs, both through the scientific truth value they bestow and through the chemical alterations they occasion … Pharmaceuticals thus work as moral technologies – they actually make the loss of social ties irreversible’. I use an Australian case study to illustrate this: about a wife’s attempts to prevent her husband being medicated, and how she unsuccessfully resists attempts to force her to abandon him. Abandonment is not only facilitated and legitimated by drugs, it is also facilitated by medical elitism, ageism and sexism – and by the imaginaries of what constitutes a ‘somebody’.