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

This chapter draws upon the CCRC as a scaffold for analysing how caregiving
(re)produces certain philosophies of time. The CCRC can be seen as a natural laboratory
for exploring the relationship between caregiving and ageing. It also highlights how the
institution frames the way time is dealt with. Because the CCRC is purposively built to
allow residents to remain within one institution for the remainder of their lives,
residents move only between floors in the same CCRC. In other words, CCRCs are
designed and marketed as places allowing people to ‘age in place.’ The rationale behind
this type of senior housing model is that moving to rooms within an institution is less
stressful than external moves, and that transitions can be better monitored and
controlled. As a result, care is segregated according to the nature of tasks, including for
example how many people it takes to help transfer a resident in and out of bed. Spatial
boundaries are thus erected between floors. Moreover, transitioning to a new floor
entails paying additional monthly fees to cover the services charged at the new level of
care. For the CCRC, ageing is a process demarcated by stages of care. Underpinning this
is a particular idea of dependency and the fear of losing of autonomy. Independence and
dependence are idiomatic and structuring principles of personhood in American society,
and are always contingent upon historical and social contexts. In a project on
perceptions of independence and dependence, researchers found that some people were
willing to cede independence in one domain in order to free up time and independence
in another (Gignac et al. 2000). According to their research findings, the elderly
perceived a greater sense of autonomy despite the fact that they were receiving help in
household chores. What mattered was that they were making a conscious decision and
link, welcoming dependence in one context, in other to free up time and resources for
another. Additionally, Kaufman presents an interesting case study of frailty in order to
seek the socio-cultural sources that constitute debates surrounding old age in America
(Kaufman 1994). Kaufman shows how frailty reveals American society's ambivalence
over issues that straddle independence and dependence. Frailty becomes a condition
that persons experience as individuals, while ageing becomes a battle for freedom and
autonomy, and set in the opposing forces of independence and dependence. In the CCRC,
the push and pulls between autonomy and dependence are constantly being negotiated
and reconceived so that a synchronic tension seems to blanket everything.
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