The purpose of this thesis has been to explore the discursive production of delirium in people over the age of 65 years. The philosophical approaches underpinning the study were derived from the field of critical gerontology, postmodernism and the utilisation of a Foucauldian understanding of discourse and power/knowledge. Data sources included published documents on delirium, interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, registered nurses and a doctor.Textual analysis revealed the presence of two contesting and contradictory discourses that impacted on being an older person who had delirium. These were identified as the discourse of delirium as a syndrome and a personal discourse of delirium. The discourse of delirium as a syndrome is underpinned by the biomedicalisation of the ageing process. This process utilises scientific methods as the foundation from which to understand, research and provide a health service to older people with delirium. Any personal perspectives on delirium are rendered unimportant and relegated to marginalised positions. Nursing through its vicarious relationship to medicine is interpellated into deploying the discourse of delirium as a syndrome and has largely ignored the personal dimensions associated with this phenomenon. Consequently, the older delirious 'body' is known and inscribed as unruly, problematic, physically unwell, cognitively impaired and at risk.Conversely, a personal discourse of delirium privileges the individual narratives of people who have been delirious and provides a different perspective of delirium. The deployment of a personal discourse of delirium offers another position that views this group of older people as bringing to the health care setting a rich tapestry of life experiences that are more than a cluster of signs and symptoms. It is these varied life experiences that need to be included as a legitimate source of knowledge about delirium. This thesis demonstrates how nursing needs to espouse a critical gerontological position when working with older people who have delirium. Critical gerontology provides nurses with the theoretical tools to challenge the status quo and uncover the multiple, varied, contradictory and complex representations of delirium in older people.

Research on aging in low income countries tends to overlook socio-cultural dimensions, including the significance of change. Because countries like Kenya are expected to witness a demographic shift in coming years, and because different forms of change will place new pressures on existing resources during the same timeframe, there is a need to bridge this gap. This study therefore grapples with the following question: How is change shaping the characteristics and needs of Kenya‘s aging population? This thesis adopts a mixed methods approach informed by critical gerontology and life course perspectives to examine the aging experiences of Pokot elders living in Marich Pass, north western Kenya, in face of multi-scalar changes. Results highlight the challenges and opportunities created by change, and illuminate a need to develop resources to support informal caregivers, to buttress existing formal supports, and to develop additional formal supports to address the unique needs of Pokot elders.

This thesis explores lifespan and intergenerational trauma effects experienced by Russian Mennonite women who fled from Stalinist Russia during WWII and migrated to Canada, and adult sons or daughters of this generation of women. As an adult child of survivors, I employed an autoethnographic methodology, conducting 1-on-1 interviews with eight women aged 78 to 96, and seven adult children aged 50 to 68. Older women demonstrated a lifelong emphasis on mental strength, faith, and resilience; the marginalization of emotions; evidence of insecure attachment styles; and potential for unresolved trauma to resurface in later life. The majority of adult children experienced attachment and identity issues; their life experiences are viewed through the lens of biological, psychological, familial, cultural (religious) transmission of trauma effects. Results highlight the importance of structural and narrative social work approaches that externalize and contextualize trauma and transform service environments that individualize and/or pathologize lifespan outcomes of trauma.

This thesis explores lifespan and intergenerational trauma effects experienced by Russian Mennonite women who fled from Stalinist Russia during WWII and migrated to Canada, and adult sons or daughters of this generation of women. As an adult child of survivors, I employed an autoethnographic methodology, conducting 1-on-1 interviews with eight women aged 78 to 96, and seven adult children aged 50 to 68. Older women demonstrated a lifelong emphasis on mental strength, faith, and resilience; the marginalization of emotions; evidence of insecure attachment styles; and potential for unresolved trauma to resurface in later life. The majority of adult children experienced attachment and identity issues; their life experiences are viewed through the lens of biological, psychological, familial, cultural (religious) transmission of trauma effects. Results highlight the importance of structural and narrative social work approaches that externalize and contextualize trauma and transform service environments that individualize and/or pathologize lifespan outcomes of trauma.

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