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Technologies of Ascription: How Does a Dementia Diagnosis Acquire its Symbolic Power of Exclusion in Later Life?

Libert, Sébastien; Higgs, Paul; (2022) Technologies of Ascription: How Does a Dementia Diagnosis Acquire its Symbolic Power of Exclusion in Later Life? Anthropology & Aging , 43 (1) pp. 1-16. 10.5195/aa.2022.355. Green open access

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Abstract

Amidst the widespread stigma and exclusion attached to dementia in dominant narratives of successful ageing, this article addresses a gap in the scientific literature concerning our understanding of the medicalization of cognitive decline as a natural phenomenon. To this end, it explores how a dementia diagnosis acquires its symbolic power of exclusion in later life through an ethnography of cognitive rehabilitation therapy in two memory clinics in a southern European nation. It argues that this symbolic power of exclusion is locally produced through the meaning making practices of therapists and researchers administering regular cognitive training therapy and exercises to support autonomy. It shows how the different steps involved in rehabilitation play a role in dividing later life by defining and reifying a category of abnormal ageing during the cognitive assessment, and by applying a confrontational approach exposing decline. It shows how this approach generates the position of older adults who can be rehabilitated against those who cannot; the latter representing a “failed” ageing in the narrative of successful ageing. This article proposes the adoption of the concept of “technologies of ascription” to characterize this process of exclusion through reification and confrontation of “abnormal cognitive decline.” The paper argues that such practices are central to the local production of the symbolic power attached to a dementia diagnosis as well as its capacity to fragment later life. Finally, it argues for the utility of this concept in offering new opportunities for anthropology to characterize exclusion in later life through medicalization.

Type: Article
Title: Technologies of Ascription: How Does a Dementia Diagnosis Acquire its Symbolic Power of Exclusion in Later Life?
Open access status: An open access version is available from UCL Discovery
DOI: 10.5195/aa.2022.355
Publisher version: http://dx.doi.org/10.5195/aa.2022.355
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. This journal is published by the University Library System of the University of Pittsburgh as part of its D-Scribe Digital Publishing Program, and is cosponsored by the University of Pittsburgh Press.
Keywords: Dementia; Exclusion; Ascription; Successful Ageing; Failed Ageing; Technology
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10146456
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