UCLA

This dissertation addresses possibilities for aging and end of life on the Caribbean island of St. Croix in the unincorporated territory of the U.S. Virgin Islands. Based on fourteen months of ethnographic fieldwork in the territory, the dissertation focuses on experiences of focal participants near the end of life, alongside the familial, institutional, and broader political and historical contexts shaping those experiences. Central to all of these domains, I argue, is disregard. Advancing disregard as a central analytic and phenomenon for understanding aging and end of life on St. Croix, I present a theoretical framework that considers the work of disregard and attention through time—over historical time at the level of the state and over the life course at the interpersonal level. I theorize disregard as manifesting through bureaucratic, interpersonal, and experiential modes, and illustrate these different modes with ethnographic cases.

Section I, “Introduction and Theoretical Framework,” introduces the study’s aims and methods, situating it within literatures in global aging and the anthropologies of care and end of life, and then advancing a theory of disregard for use within anthropology. Section II, “A History of Disregard,” presents a history of St. Croix from European colonialism to the present, arguing that St. Croix has for centuries been positioned as a disregarded space on the periphery of the nation. Section III, “Bureaucratic Disregard” begins the ethnographic portion of the dissertation through an exposition of the landscape of senior healthcare and services on St. Croix at the time of research followed by two ethnographic cases that show how disregard is disclosed through aspects of Medicare bureaucracy that deeply impact end-of-life possibilities for older adults on the island. Section IV, “Embodiments of Bureaucratic Disregard” presents the case of one woman living on St. Croix whose final months were shaped in large part by the forms of bureaucratic disregard described in the previous section.

Section V “Caregiving and Intimate Forms of Disregard” turns to interpersonal forms of disregard through addressing a common caregiving structure on St. Croix in which only one family member, in the midst of large families, is providing caregiving for an older relative. Section VI “Experiencing Disregard,” turns to the experiential workings of disregard through examining one woman’s embodied, mooded experiences of disregard during the last three weeks of her life. In the conclusion, in addition to a brief integration of the dissertation’s arguments, I speak to how the effects Hurricane Maria—a storm which hit St. Croix one year after fieldwork ended—has dramatically re-shaped possibilities for care on the island. I focus in particular on how the process of recovery discloses the ongoing role of disregard in shaping experiences and possibilities for older adults on St. Croix.