The dark at the bottom of the stairs: performance and participation of hospitalized older people.

Like all social actors, older people draw on cultural meanings to perform identity. However, when advanced aging brings loss of status as full persons, particularly when it is associated with sickness and dependency, older people can be deemed unsuitable for active medical treatment and care. In addition, loss of status may make it difficult for older people to influence how they and their needs and wants are identified, and how their future life (or death) is conceived. This article discusses how some older people who are admitted to hospital as acute medical emergencies participate in staff's discursive practices to establish a positive clinical identity. By lying low and effacing their distinctiveness as individuals and as social beings, some older people are able to maintain their inclusion in positive medical categories. The article argues that older people are committed to their inclusion in the medical domain because their association with positive medical categories helps them keep at bay the inchoate, the dark at the bottom of the stairs.