Lorna Tilley

Corrigendum to “Disability and care in Western Europe during Medieval times: A bioarchaeological perspective” [Int. J. Paleopathol. 44 (2024) 119–125]

International journal of paleopathology, Apr 1, 2024

Tilley and Cave 2023 Applying the bioarchaeology of care to early Anglo Saxon remains

International Journal of Paleopathology, 2023

Abstract Objective To test the hypothesis that a bioarchaeological focus on health-related care p... more Abstract
Objective
To test the hypothesis that a bioarchaeological focus on health-related care provision can contribute to the currently limited understanding of social practice in Early Anglo-Saxon England (mid5th-early7th centuries AD).

Materials
Published descriptions of pathology in 69 adult remains from the Early Anglo-Saxon cemetery of Worthy Park, southern England.

Methods
Three case studies (one examining likely need for care at an individual level and two at a population level) were undertaken using the bioarchaeology of care approach.

Results
Analyses indicate likely care provision (‘direct support’ and/or ‘accommodation of difference’) to Worthy Park individuals experiencing temporary or permanent disability. Interpretation suggests community interdependence, cooperation, flexibility and tolerance of difference, as well as cultural and socioeconomic mechanisms for managing physical and social challenges of ageing.

Conclusions
This study provides proof of concept that bioarchaeology of care analysis can offer new insights into social practice in this period.

Significance
This study demonstrates that a bioarchaeological focus on caregiving behaviours in an Early Anglo-Saxon community extends modern thinking about social relations in post-Roman Britain, offering a model for future investigations into social practice in this, and potentially other, periods. More generally, it illustrates the richness of results achievable when combining bioarchaeological and historical research.

Limitations
Reliance on secondary sources limited detail (and potentially accuracy) of interpretation possible.

Suggestions for further research
This study’s approach should be further tested and refined, either through application to different Anglo-Saxon (or other historic) populations or in a more thorough analysis of the Worthy Park sample itself.

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Tilley 2022 Disability and care in the bioarchaeological record Abstract

The Routledge Handbook of Paleopathology, 2022

Only in the last decade has archaeology come to accept that a research focus on past disability e... more Only in the last decade has archaeology come to accept that a research focus on past disability experience and associated health-related caregiving behaviors provides valuable, often intimate, insights both into individual care-recipients and their caregivers, and into the wider cultural, social and economic lifeways these actors inhabit. This chapter discusses the what, how and why of applied bioarchaeological research into disability and care. The first section focuses on what exactly we are considering: what definitions of 'disability' and 'care' are most appropriate for use in analysis (and how debate around these definitions might be addressed); what principles underlie the research process; and what obstacles exist to establishing disability and care from archaeological evidence alone. The second section looks at how research into past disability and care is undertaken in practice, using multiple examples to illustrate the way assessment of disability is derived from contextualised indicators of pathology in human remains; how this assessment allows inference of the features of care likely required; and how interpretation of this caregiving might be approached in order to achieve increased understanding of community social organisation and social relations. Although still a new field in paleopathology, research into past disability and care has found an extraordinary resonance amongst practitioners and general public alike. The final section examines why this is the case, and how bioarchaeology can build on this phenomenon to contribute to modern-day discourse in these areas.

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Towards a bioarchaeology of care : a contextualised approach for identifying and interpreting health-related care provision in prehistory

Characteristics of the care given to those experiencing disability provide a window into importan... more Characteristics of the care given to those experiencing disability provide a window into important aspects of community and culture. In archaeology, health-related care provision is inferred from physical evidence in human remains indicating survival with, or recovery from, a disabling pathology, in circumstances where, without support, the individual may not have survived to actual age at death. Despite its potential to provide a valuable perspective on past behaviour, caregiving is a topic that has been overlooked by archaeologists. This thesis presents the 'bioarchaeology of care' - an original, fully-theorised and contextualised case study-based approach for identifying and interpreting disability and health-related care practices within their corresponding lifeways, and one that seeks to reveal elements of past social relations, socioeconomic organisation and group and individual identity which might otherwise be inaccessible. The applied methodology comprises four stages of analysis: (i) description and diagnosis; (ii) establishing disability impact and determining the case for care; (iii) deriving a 'model of care'; and (iv) interpreting the broader implications of care given. Each stage builds on the contents of preceding one(s), facilitating scrutiny of the analytical process. This dissertation first discusses the treatment of healthcare provision in archaeological research, considering where, and why, this has fallen short. Successive chapters establish a context and a conceptual foundation for undertaking archaeological research into health-related caregiving, which includes operationalising terminology surrounding issues of 'disability' and 'care'; exploring the social and biological evolutionary origins of caregiving, and the implications of these for understanding prehistoric care practice; and presenting a framework for deconstructing the decision-making involved in giving and receiving care. The thesis then details the stages of the methodology and introduces the Index of Care, a computer-based in [...]

Introducing the Bioarchaeology of Care

Bioarchaeology and social theory, 2015

Where health-related care practices can be inferred from the bioarchaeological record, these may ... more Where health-related care practices can be inferred from the bioarchaeological record, these may offer unique insights into both the caregiving community and the individual care-recipient. The ‘bioarchaeology of care’ provides both a conceptual and an applied framework for analysing bioanthropological and archaeological indicators of health-related caregiving practice and, as a consequence, offers the opportunity to deepen our understanding of the past. Chapter 1 introduces the bioarchaeology of care approach, provides brief definitions of key terms and concepts employed in this book, and notes some of the limitations facing any research into past care practice. It explains the parameters adopted in developing bioarchaeology of care theory, gives a short description of the applied methodology, and goes on to explain the scope, aims and structure of this book and outline chapter content. In conclusion, it discusses some of the challenges faced by all archaeological research dealing with subject matter as contested as that of ‘disability’ and ‘care’, and presents a personal response to these.

Disability and Care in the Bioarchaeological Record

Routledge eBooks, Dec 2, 2022

Towards a bioarchaeology of care : a contextualised approach for identifying and interpreting health-related care provision in prehistory

Characteristics of the care given to those experiencing disability provide a window into importan... more Characteristics of the care given to those experiencing disability provide a window into important aspects of community and culture. In archaeology, health-related care provision is inferred from physical evidence in human remains indicating survival with, or recovery from, a disabling pathology, in circumstances where, without support, the individual may not have survived to actual age at death. Despite its potential to provide a valuable perspective on past behaviour, caregiving is a topic that has been overlooked by archaeologists. This thesis presents the 'bioarchaeology of care' - an original, fully-theorised and contextualised case study-based approach for identifying and interpreting disability and health-related care practices within their corresponding lifeways, and one that seeks to reveal elements of past social relations, socioeconomic organisation and group and individual identity which might otherwise be inaccessible. The applied methodology comprises four stages of analysis: (i) description and diagnosis; (ii) establishing disability impact and determining the case for care; (iii) deriving a 'model of care'; and (iv) interpreting the broader implications of care given. Each stage builds on the contents of preceding one(s), facilitating scrutiny of the analytical process. This dissertation first discusses the treatment of healthcare provision in archaeological research, considering where, and why, this has fallen short. Successive chapters establish a context and a conceptual foundation for undertaking archaeological research into health-related caregiving, which includes operationalising terminology surrounding issues of 'disability' and 'care'; exploring the social and biological evolutionary origins of caregiving, and the implications of these for understanding prehistoric care practice; and presenting a framework for deconstructing the decision-making involved in giving and receiving care. The thesis then details the stages of the methodology and introduces the Index of Care, a computer-based in [...]

Introducing the Bioarchaeology of Care

Theory and Practice in the Bioarchaeology of Care, 2015

Where health-related care practices can be inferred from the bioarchaeological record, these may ... more Where health-related care practices can be inferred from the bioarchaeological record, these may offer unique insights into both the caregiving community and the individual care-recipient. The ‘bioarchaeology of care’ provides both a conceptual and an applied framework for analysing bioanthropological and archaeological indicators of health-related caregiving practice and, as a consequence, offers the opportunity to deepen our understanding of the past. Chapter 1 introduces the bioarchaeology of care approach, provides brief definitions of key terms and concepts employed in this book, and notes some of the limitations facing any research into past care practice. It explains the parameters adopted in developing bioarchaeology of care theory, gives a short description of the applied methodology, and goes on to explain the scope, aims and structure of this book and outline chapter content. In conclusion, it discusses some of the challenges faced by all archaeological research dealing with subject matter as contested as that of ‘disability’ and ‘care’, and presents a personal response to these.

Helping to shine light on the Dark Ages: Applying the bioarchaeology of care approach to remains from the early Anglo-Saxon cemetery at Worthy Park

International Journal of Paleopathology

Tools of Change: New Technology and the Democratisation of Workby John Mathews(Pluto Press, Sydney, 1989) $14.95, ISBN 0949 13822 3

Prometheus (St. Lucia), Jun 1, 1990

Mummy studies and the bioarchaeology of care

International Journal of Paleopathology, 2019

The bioarchaeology of care is a framework through which researchers can begin to infer the level ... more The bioarchaeology of care is a framework through which researchers can begin to infer the level of care an
individual may have required based on the presence of paleopathological evidence. To date, all of the research
that has employed the framework has been based on evidence derived from skeletal material. This special issue
was organized in order to highlight how the analysis of mummified soft tissue, as well as other sources of data
commonly associated with mummified remains, such as coprolites and intestinal contents, has the potential to
provide valuable insight into the reconstruction of care in the past.

Open Access: Calculated or caring? Neanderthal healthcare in social context

Routledge eBooks, Apr 5, 2022

Explanations for patterns of healed trauma in Neanderthals have been a matter of debate for sever... more Explanations for patterns of healed trauma in Neanderthals have been a matter of debate for several decades. Despite widespread evidence for recovery from injuries or survival despite impairments, apparent evidence for healthcare is given limited attention. Moreover, interpretations of Neanderthals' approach to injury and suffering sometimes assume a calculated or indifferent attitude to others. Here the authors review evidence for Neanderthal healthcare, drawing on a bioarchaeology of care approach and relating healthcare to other realms of Neanderthal social life. The authors argue that Neanderthal medical treatment and healthcare was widespread and part of a social context of strong pro-social bonds which was not distinctively different from healthcare seen in later contexts. They suggest that the time has come to accept Neanderthal healthcare as a compassionate and knowledgeable response to injury and illness, and to turn to other questions, such as cultural variation or the wider significance of healthcare in an evolutionary context.

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Thinking and Theory in the Bioarchaeology of Care

Reflections on life and times in Neolithic Vietnam

Caring in Ancient Times

Anthropology News, 2018

A ‘cold case’ of care: Looking at old data from a new perspective in mummy research

International Journal of Paleopathology, 2019

In 1973, analysis of the mummified remains of a young boy dated to 700AD and from the Late Nasca ... more In 1973, analysis of the mummified remains of a young boy dated to 700AD and from the Late Nasca period (Peru) identified (i) chronic Pott's disease, leading to loss of lower body mobility, and (ii) acute miliary tuberculosis, affecting most organs and the immediate cause of death (Allison et al., 1973). This report was the first to establish, beyond dispute, the presence of tuberculosis in the Americas before the arrival of Europeans. Here, we revisit the 'Nasca Boy' from a bioarchaeology of care perspective. Contextualising the original study's results within what is known of contemporary lifeways, we apply the bioarchaeology of care methodology in considering the Nasca Boy's experience of living with tuberculosis; the type of care he required and how this may have evolved over a period of deteriorating health; and what such caregiving may suggest both about social organisation within his community and some of the more everyday aspects of Nasca existence. Up to now, the bioarchaeology of care approach has been employed almost exclusively with skeletal evidence; in this analysis of the Nasca Boy's remains, and in the accompanying wider-ranging discussion, we illustrate the potential of preserved soft tissue evidence to contribute to research into disability and care in the past. Although this report functions as a stand-alone case study, to obtain maximum benefit it should be read in conjunction with the Introduction to the special International Journal of Paleopathology issue on 'mummy studies and the bioarchaeology of care' (Nystrom and Tilley, 2018).

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Calculated or caring? Neanderthal healthcare in social context

World Archaeology, 2018

Explanations for patterns of healed trauma in Neanderthals have been a matter of debate for sever... more Explanations for patterns of healed trauma in Neanderthals have been a matter of debate for several decades. Despite widespread evidence for recovery from injuries or survival despite impairments, apparent evidence for healthcare is given limited attention. Moreover, interpretations of Neanderthals' approach to injury and suffering sometimes assume a calculated or indifferent attitude to others. Here the authors review evidence for Neanderthal healthcare, drawing on a bioarchaeology of care approach and relating healthcare to other realms of Neanderthal social life. The authors argue that Neanderthal medical treatment and healthcare was widespread and part of a social context of strong pro-social bonds which was not distinctively different from healthcare seen in later contexts. They suggest that the time has come to accept Neanderthal healthcare as a compassionate and knowledgeable response to injury and illness, and to turn to other questions, such as cultural variation or the wider significance of healthcare in an evolutionary context.

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Mummy studies and the bioarchaeology of care

International journal of paleopathology, Jan 12, 2018

The bioarchaeology of care is a framework through which researchers can begin to infer the level ... more The bioarchaeology of care is a framework through which researchers can begin to infer the level of care an individual may have required based on the presence of paleopathological evidence. To date, all of the research that has employed the framework has been based on evidence derived from skeletal material. This special issue was organized in order to highlight how the analysis of mummified soft tissue, as well as other sources of data commonly associated with mummified remains, such as coprolites and intestinal contents, has the potential to provide valuable insight into the reconstruction of care in the past.

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Showing That They Cared: An Introduction to Thinking, Theory and Practice in the Bioarchaeology of Care

New Developments in the Bioarchaeology of Care, 2016

Indicators of the lived experience of disease are frequently found in archaeologically recovered ... more Indicators of the lived experience of disease are frequently found in archaeologically recovered human remains. Where evidence suggests a period of survival with pathology likely to have compromised an individual’s ability to function independently, or to participate appropriately, within their lifeways setting, it can be inferred that this person likely received a level of health-related care to assist them in managing disease impact – and the characteristics of this caregiving may offer insights into important aspects of community and culture. The bioarchaeology of care is a recently developed, case study-based approach for identifying and interpreting instances of past disability and associated care responses within the corresponding archaeological context, and it is supported by the Index of Care, an online application designed to assist in working systematically through the four stages of bioarchaeology of care analysis. This chapter is an introduction to bioarchaeology of care theory and practice for readers who are not already familiar with these and serves as background for the following chapters in this volume. Drawing on the examples of two prehistoric individuals (Man Bac Burial 9, from Neolithic Vietnam, and Romito 2, from Epigravettian Italy) thought to have received very different forms of care, the chapter describes the bioarchaeology of care methodology, summarising the principles shaping its design, its scope and its limitations. It outlines both the most commonly voiced objections to the archaeological inference of care and the conceptual foundations on which the new approach was constructed. In closing, the chapter briefly considers why it is important for archaeology to acknowledge the implications of the giving and receipt of care wherever evidence permits – in terms of enriching academic knowledge; realising our ethical obligations to the individuals whose remains we analyse and whose lives we (re)produce; and providing a perspective on past life and behaviour that may help inform debate on behaviours in the present.

Introduction: New Developments in the Bioarchaeology of Care

New Developments in the Bioarchaeology of Care, 2016

This chapter introduces the edited volume New Developments in the Bioarchaeology of Care: Further... more This chapter introduces the edited volume New Developments in the Bioarchaeology of Care: Further Case Studies and Extended Theory. It outlines the context for, and the history of, the book’s evolution, and explains the basis on which the chapters have been organised into three sections: (i) case studies; (ii) new research directions; and (iii) ethics and accountability. The Introduction goes on to provide a short description of the subject matter and specific focus of each chapter, before briefly identifying some of the common themes, shared concerns and innovative approaches emerging from this book’s original and challenging content.

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