Self, Senility, and Alzheimer's Disease in Modern America: A History

257 Pages·2006·1.07 MB·English

by  Jesse F. Ballenger

Self, Senility, and Alzheimer’s
Disease in Modern America
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Self, Senility, and Alzheimer’s
Disease in Modern America
A History
jesse f. ballenger
The Johns Hopkins University Press
Baltimore
∫ 2006 The Johns Hopkins University Press
All rights reserved. Published 2006
Printed in the United States of America on acid-free paper
2 4 6 8 9 7 5 3 1
The Johns Hopkins University Press
2715 North Charles Street
Baltimore, Maryland 21218-4363
www.press.jhu.edu
Library of Congress Cataloging-in-Publication Data
Ballenger, Jesse F.
Self, senility, and Alzheimer’s disease in modern America : a history /
Jesse F. Ballenger.
p. cm.
Includes bibliographical references and index.
isbn 0-8018-8276-1 (hardcover : alk. paper)
1. Alzheimer’s disease—United States—History—20th century. I. Title.
[dnlm: 1. Alzheimer Disease—history—United States. 2. Attitude to Health—
United States. 3. Self Concept—United States. 4. History, 20th Century—United
States. 5. History, 19th Century—United States. wt 11 aa1 b191s 2006]
rc523.b25 2006
362.196%831—dc22 2005012140
A catalog record for this book is available from the British Library.
For David D. Van Tassel (1928–2000)
Know the past, be the future . . .
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Contents
Preface ix
Acknowledgments xv
Introduction 1
1 The Stereotype of Senility in Late-Nineteenth-Century America 11
2 Beyond the Characteristic Plaques and Tangles 36
3 From Senility to Successful Aging 56
4 The Renaissance of Pathology 81
5 The Health Politics of Anguish 113
6 The Preservation of Selfhood in the Culture of Dementia 152
Notes 189
Index 231
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Preface
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
‘‘total care’’ cases on the geriatric wards: old, frail, chronically ill patients who
needed to be helped with every aspect of their physical functioning—moving,
bathing, dressing, eating, excreting—and who were more often than not at least
mildly confused and in many cases in advanced stages of dementia.
During the years I worked in hospitals, Alzheimer’s disease emerged from
obscurity to become the dominant diagnostic category and way of representing
dementia in old age. I recall an in-service training in which nursing assistants
were indoctrinated in the new language of Alzheimer’s disease. ‘‘There is no such
thing as senility,’’ we were taught. When aged people became chronically con-
fused, it was not simply a matter of getting old; they in fact had some kind of
disease, most commonly Alzheimer’s, and should not be stigmatized as senile.
When, as a graduate student in history, I looked back on this experience, it
seemed that such a dramatic transition in how we understand and talk about
dementia was worth examining as a historical phenomenon.
As I explored the ways in which this transition in the terminology used to
describe age-associated dementia might be more broadly connected to American
culture, I was eventually drawn back to my experience taking care of these pa-
tients. Working through the popular and professional literature on Alzheimer’s, I
became particularly interested in the issue of fear: Why was Alzheimer’s so
widely regarded as the worst and most devastating of all possible diseases—the
‘‘funeral that never ends’’? The answer seemed to be that Alzheimer’s somehow
destroyed the selfhood of people with the disease, that the destruction of brain
tissue entailed a destruction of abilities and qualities essential to people’s identity,