Health-Related Caretaking in an Institutionalized Setting: Applying the Index of Care to Burial 1 from the Mid-Nineteenth- to Early Twentieth-Century Mississippi State Asylum, Jackson, MS.

Health-related caretaking was provided to individuals institutionalized in the Mississippi State Asylum (MSA), Jackson, MS (AD 1855-1935). However, because of limited associated documentary evidence on caretaking in the MSA and a general dearth of academic knowledge about caretaking in asylums in the Southern United States, information on caretaking and its efficacy in the MSA is limited. Accordingly, we apply a modified Bioarchaeology of Care (BoC) approach and associated web-based Index of Care to a single deceased individual from the MSA, referred to here as their burial designation--Burial 1--integrated with available documentary information, to generate direct insights into caretaking in the MSA. Burial 1's skeleton exhibits recidivistic cranial trauma (i.e., cranial depression fractures) and substantial entheseal changes in the upper extremities. This trauma, paired with subsequent traumatic brain injury, suggests that Burial 1 may have experienced physical impairment and disability. Further, the disability Burial 1 experienced likely increased their risk of being institutionalized and created complications for them in the MSA. However, the lack of identifying information for individuals buried at the MSA complicates interpretations of the caretaking they may have received, both before and after institutionalization, as well as the efficaciousness of the caretaking and insights from the caretaking into patient and staff communities in the MSA and Burial 1's social identity and agency. Despite this, findings affirm that future research applying the modified BoC approach could generate otherwise inscrutable information about the lived experiences of institutionalized patients with impairments and disability within historic institutions of care. [ABSTRACT FROM AUTHOR]