Philip Y. Kao PhD thesis - Research@StAndrews:FullText

Conclusion: Ageing as a Spatial Project and Temporal Process
This study has sought to explore personhood, kinship and social relations arising from
the context of a long-term care facility. Even though the present analysis is not an
institutional ethnography in the strict sense, a modified and broader concept of practices
and institutions has permeated much of my analysis. A broad conception of the
institution, as promoted by Durão and Lopes, suggests that we “[…] look at institutions
as ingenious combinations of personalities and materialities, where identity and family
issues appear side by side with expertise and technocracy instead of treating the two
realms separately” (Durão and Lopes 2011, 364). In Tacoma Pastures, we see how issues
of care, ageing and relations interact, bringing forth a kind of stability that at once
continues over time even as it transforms itself. For the residents at Tacoma Pastures,
the ageing process is enacted by various spatio-temporal arrangements and caregiving
regimes. People moved to Tacoma Pastures under varying circumstances and for slightly
different reasons, but in the end, someone chose Tacoma Pastures as a final living
destination. Because Tacoma Pastures is a CCRC, i.e. a purpose-built retirement
community for residents to age in place, the residents who are there have ceded away
much control over their lives. They have done this so that the remainder of their days
and nights can be met with some degree of certainty. This certainty stems from the belief
that with the help of the staff at Tacoma Pastures, certain aspects of their lives will be
sorted out. No matter how they age, and what debilitating diseases lie down the road,
they believe that systemic arrangements for living quarters, security, and assistance
with medical needs and the activities of daily living will follow them on Tacoma
Pastures’s ‘Journey of Life.’
What began for me as an investigation into how people age and inhabit the world of a
long-term care facility soon turned into a more focused account of caregiving. My shift in
focus was partially the outcome of the fieldwork, and in particular how I came to work as
a caregiver, whilst maintaining my anthropological position. Because the exigencies of
ageing, arising from the social and cultural context of the American Midwest community,
demanded certain exigencies of care, I decided to cast my analysis around the
interactions among and between the caregivers and the residents. More specifically, I
began to notice how care was conceptualised, broken down and reconstituted daily. Care
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