Paper short abstract:

Using ethnographic insights from fieldwork at a Continuing Care Retirement Community in Los Angeles, this paper suggests that transitions in an elder's care are intense sites of contestation, disturbing not simply the organization of care, but, through it, the recognition of life itself.

Paper long abstract:

Addressing the rupturing transitions Americans make at the end of life between home and medical institution, Continuing Care Retirement Communities (CCRC) seek to handle elders' uncertain aging and dying seamlessly, offering escalations of care - from independent, assisted, to nursing - in one community. This 'aging in place', from retirement to death, allows elders the time to establish kin-like, enduring solidarity with friends and staff, helping to transform the impersonal institution into a unified home. While CCRCs help to integrate elder's transition between levels of care, transitions there nevertheless feel dislocating, because the variant logics of care within independent, assisted and nursing living diversely shape elders' sociality, personhood, and life.

Ethnographically inspired, this paper examines how transitions in an elder's care are intense sites of contestation, disturbing not simply the organization of care, but, through it, the recognition of life itself. These contestations are severe, because elders know that these levels of care do not simply reflect reality, but in fact create it: while it was known that the body in its last months needs professional oversight, the nursing home was also seen to quicken death, as its induced dependence takes away the 'will to live' and as its zone of death makes social solidarity difficult. This paper reflects on how places and their logics of care create life and death through practice and perception. It also suggests transitions at the end of life are critical sites for existential quandary and death's social formation.