Self, Senility, and Alzheimer's Disease in Modern America

Contents

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pp. vii-

Preface

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pp. ix-xiv

The roots of this book stretch back twenty years, long before I had any idea that something like a cultural history of senility and Alzheimer’s disease was possible, let alone that I would write one. Between the time I graduated from high school in 1979 and began work on a Ph.D. in history in 1992, I worked as a nursing assistant in a couple of medium-sized general hospitals. I was typically assigned ...

Acknowledgments

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pp. xv-xvii

Many people in different ways have helped to make it possible for me to write this book. The Department of History at Case Western Reserve University, where this project began as a doctoral dissertation, was a particularly rich place to engage in this sort of inquiry, and in particular the mentorship of a number of faculty members at Case has been crucial. When I entered the program, David Hammack ...

Introduction

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pp. 1-10

This is not another book about scientific progress in unraveling the mystery of Alzheimer’s disease; nor is it an analysis of particular ethical or policy issues, and still less a compendium of advice and practical tips for the caregiver or professional on managing dementia. There are many, many of these already. Rather, it is a book about the peculiar dread that dementia generates in American society. It ...

1. The Stereotype of Senility in Late-Nineteenth-Century America

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pp. 11-35

In February 1905, William Osler, the most famous and idolized physician in the United States, if not the world, delivered what would soon become perhaps the most infamous assessment of aging in American history. Men above 40 years of age were comparatively useless, he claimed, while men over 60 were completely useless and, to the extent that they retained their positions, in fact caused ...

2. Beyond the Characteristic Plaques and Tangles

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pp. 36-55

Over the first half of the twentieth century, American psychiatry became increasingly interested in the problem of senile dementia. At least initially, psychiatrists did not find it inherently interesting as a medical problem. As the medical literature described in the previous chapter suggests, senile mental deterioration did seem rather easy to explain away as an inevitable part of aging for which there ...

3. From Senility to Successful Aging

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pp. 56-80

By the mid-1930s, and much more intensely following World War II, middle-class discourse on old age was reshaped by the emergence of gerontology and related endeavors as a field of research and practice for a diverse array of biomedical and social scientists, policymakers, activists, and entrepreneurs interested in the ‘‘gray market.’’∞ These various groups, only loosely allied and at times ...

4. The Renaissance of Pathology

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pp. 81-112

In the late 1960s, a growing coterie of psychiatrists and neurologists began to take a fresh look at the problem of dementia in old age. To this group of researchers, the broad concept of ‘‘senility’’ that had been developed a generation earlier by psychodynamic psychiatrists and embraced by gerontologists and other professionals concerned with aging in the 1950s and 1960s seemed archaic at ...

5. The Health Politics of Anguish

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pp. 113-151

On 15 September 1983, the U.S. House of Representatives passed a resolution declaring November of that year National Alzheimer’s Disease Month. The representatives who spoke in support of the resolution recited a litany of arguments and statistics that would have been familiar to anyone remotely familiar with the professional and popular literature on aging and dementia of the previous few ...

6. The Preservation of Selfhood in the Culture of Dementia

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pp. 152-188

In Stephen Post’s critique of the idea, dominant in bioethics, that the cognitive losses of dementia make it unnecessary and perhaps impossible to regard people with dementia as fully possessed of the moral status of personhood, he suggests that fellow bioethicists who espouse such views are practically irrelevant: ‘‘Nobody would approach a family in the throes of medical decision making about ...

Notes

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pp. 189-230

Index

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pp. 231-236