Ayahs at the deathbed re-visioning elder care: bereavement support and anchorage for in-home dying older adults in urban India

Extending life and delaying death through medicalisation and technologisation has reinvigorated interests in the long-term care and unmet needs of the elders. In continuity to an expert-regime, end-of-life care is treated as a specialty to be studied separately to claim authority of knowledge. Such gatekeeping iteratively endorsed through the Euro-centric discourses in the Global North, tend to universalize and homogenize the experiences of death, and practices of care, eclipsing notions and perceptions around death as culturally situated and historically contextualised. In a response, this paper reimagines innovation through a dually-layered paradigm shift - a site and source of knowledge production – embodied, affective and lived experience through the marginalized subjectivities of the ayahs. Also, the Global South, the much neglected and subordinated geographical axis. Both these sites of marginalization are legitimate and powerful in shaping and re-visioning a bottom-up approach to end-of-life care. Emerging as frontline care actors, ayahs lend a unique vantage point to identify ‘decrepit death’, respectful dying, and care across the life course and old-age knitting together immersion, relational affective care, and tethered and entwined living. Building on ethnographic insights, qualitative in-depth interviews and family case studies, the paper upholds a culture-sensitive standpoint to devise and rethink old-age care.