The Dark Side:Stigma in purpose-built senior environments.

This paper focuses on stigma in collective living environments for older adults, specifically multi-level campuses. We contrast two design profiles, a purpose-built campus which opened in 1997, and an older setting that grew by accretion over decades. Purpose-built housing is used as originally intended, designed, and constructed; housing built by accretion has been modified over time to meet changing needs and uses. The separation by care levels in both sites is reflected in their cultures as residents and staff relate to physical levels of care through a vocabulary of fear and stigma. Residents of the independent living building on the purpose-built campus refer to the assisted living building, accessed only through a second floor link, as "the other side" or "the dark side." In this setting we observe stigma assigned to a place in the built environment. By contrast, in the older setting built by accretion over the last century, levels of care feature a less-structured clustering of independent living and assisted living, and common areas were shared by residents from multiple care levels. We have observed less stigma associated with levels of care in this older building. Grounding our analysis in data drawn from ongoing ethnographic research, we focus on the built environment as it relates to stigma in the social environment. The paper concludes with a discussion of the importance and pervasiveness of stigma in senior environments.