People come here to die: Winnicott and the the trauma of old age 

This essay draws on my experience with a continuing care retirement community (CCRC).  It is an essay on trauma–the trauma of old age and impending death.  The CCRC serves as what D. W. Winnicott calls a transitional object.  Only in the case of the CCRC, it’s a transitional object in reverse.  That’s good and bad.  Mostly it’s interesting, especially for me, since I live in one.  

People come here to die.  A CCRC, of which there are over 2,000 in the United States, provides independent living, assisted living, and nursing home care under one roof in the smaller communities.  The larger CCRCs often occupy a campus, but the same principle applies.  I live in one of the smaller CCRCs, with about 200 residents in independent living.

My wife died close to five years ago now.  I lived alone in a big house for about two years.  Keeping up the house and living alone became too much, and I moved to the CCRC.  I’ve lived here now for almost three years.  

The CCRC as transitional object in reverse

I’ve thought a lot about the psychology of living in a CCRC.  What set me off was the remark by my first friend here.  He said people don’t make close friendships in retirement communities because they know their friends will soon die.  My friend died about a year after I met him (he was in his 90s), and I think what he said was only partly true.  

The CCRC serves as a transitional object.   What’s unusual about the CCRC is that it’s a transitional object in reverse.  The infant and young child’s use of the transitional object serves to help him or her separate me from not-me, and so move from dependence to relative independence.  The CCRC is the opposite, helping the residents move from independence to relative dependence.

The flipper is a good example, the first step in this move.  The flipper is a little tear-drop-shaped piece of wood that swings on the outside of the independent living resident’s door.  A worker pushes it against the door late at night, and it flips to a down position when I open the door in the morning.  If the door isn’t opened by about 11am, the flipper stays up, and someone checks to see if I’m dead or seriously ill.  

The flipper is the first step in a series of events—call them care—that usually eventuate in the resident dying in the nursing facility in an adjacent building. 

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