SOCIAL CHANGE - FAMILY AND AGED CARE

Yaacob Harun
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INTRODUCTION

The family, has always been the place where one finds love, companionship,
comfort, and solitude. Rapid change that occurs in all spheres of society does
not reduce the status of the family as the basic institution in society.
However, the process of structural differentiation has robbed the family of
its major functions, notably the economic, the educational, and the
protective functions, if not totally, but to share them with specialized
agencies such as the factory, the school system, the police, civic bodies,
welfare organizations, and others. Nevertheless, the basic reproductive,
emotive functions, and to a certain the protective function (including care
for the young, the aged, and the infirm) still remain within the confines of
the family system.

This paper intends to discuss (briefly) issues related to aged care in the
context of the changing family system. Modern families, especially those
found in the cities are not able to provide or to extend such care for the aged
and the infirm as it was expected of them to do so. Factors like urban
residence, work demands and the changing conjugal roles, lack of resources,
and new value orientations are some, but not only the likely constraints that
hinder the extension of care to those mentioned.

URBAN RESIDENCE

By taking up urban residence, it means a person is physically detached from

the family circle. Contacts with parents and relatives gradually become less
frequent. Over the years of detachment, family obligations and expectations
towards those who are still living in the villages seem to wither. Aged parents
are normally left in the care of relatives, if there is any, who are staying in the
same villages. Only, in times when the parents are critically ill do the children
make their presence felt in the family homes. Even so, they are not there for
long. It is lucky for the parents if they have a number of children who can
take turn to look after them in times of need. Otherwise, they have to fend
for themselves if they still insist on staying in the village and not move to be
with their children who have migrated to the city or to other places where
they take up employment.

A study carried out on 1614 urban Malay families in Klang Valley, Ipoh,
Penang, Johor Bharu, Kuching, and Kota Kinabalu in 1995 shows that the
majority (91.2%) of 1401 families who still have surviving parents aged
between 60 and 90 and above, mentioned that their parents are staying on
their own in their respective villages. Only 21 families or 1.5 percent of those
families reported that their aged parents are staying with them. Quite
surprisingly, about 7.3 percent of the urban families with surviving parents
mentioned that their parents are staying in old folks' homes. (Yaacob Harun
et.al, 1997:113). This means to show that the majority of the parents prefer
to be on their own their villages rather than move to stay with their children
in the cities.

In fact, most elderly parents do not need much active care. They are quite
capable of managing for themselves as they have done throughout the life-
course. As Graham Allan says, "They may be that much frailer and find
some activities harder to complete, but they generally have no desire to be
seen as dependent on their children" (1996:63). However, there are limits to
this. If elderly parents (especially so if both of them) become infirm, then at
least one child, particularly the one who is staying nearby, either in the same
village or in another village will become more involved in providing care and
a level of support. The pattern of care is greatly influenced by the structure
and nearness of the family. If daughters were available, particularly the
youngest, they were the ones to help. If they were not, then the duty passed
to daughters-in-laws, sisters and neices. (Townsend, 1957)

To move to stay with the children in the city is a decision taken after all
possible alternatives have been exhausted. The constraint of space in urban
living is one of the factors that hinder children to accommodate aged
parents. Only very few can afford to provide proper accommodation to their
folks as well to attend to their needs. The situation is made worse if their
elderly is sick and bed-ridden. I am of the opinion, that, because of this
consideration that a certain percentage (7.3%) of the respondents in our
study mentioned that their elderly parents are placed in the old folks' homes.
To me, this is a better choice to make than to opt to stay in a crowded one
or a two-roomed apartment with their married children in the city. A point
to note that some of the elderly Malays of rural Malaysia especially those
found in the northern states of Perlis, Kedah and Kelantan, will seek
"refuge" in the institution of the pondok. The pondok is not only the place
where one studies religion, but also a place for old people to stay among
themselves, to be free from family obligations and commitments so that they
can spend whatever time they have left to intensify their religious
understandings and devotions to God.

WORK DEMANDS AND

THE CHANGING CONJUGAL ROLES

The predominance of single income family whereby the husband is the only
breadwinner is a phenomenon of the past. Today, more women are entering
the job market outside the family. Based on our study (1995), out of 1397
families who responded when asked about the spouses' occupations, 60.1
percent mentioned that both husband and wife are working, and only 39.9
percent of the wives are not working. The working wives are no longer
confined to playing the traditional role as homemaker or as wife-mother.
Alongside with their husbands they have become active contributors to
family income, and not surprisingly, some are earning much more than their
husbands. As a result, this gives them more voice in family matters, and at
the same time, reduce the dominant role positions of their husbands.
Generally, families today are more democratic where family decisions are
collectively by both spouses.

When women are active participants in the job market, they can no longer
devote their time solely to handling family matters including child and aged
care. Research literature which have been built up since the early 1980s
demonstrates very clearly that daughters and daughters-in-law carry a far
heavier burden of caring than sons or sons-in-law. Nissel and Bonnerjea's
(1982) finding that women in households in which there lived an infirm
elderly parent spent on average two to three hours per day providing active
care, whilst their husbands spent on average only eight minutes (c.f. Allan,
Op.cit:72). Tania Li in her study on the Malays in Singapore (1989) also says,
daughters are thought to be a more reliable source of support in old age than
sons. I believe this is due to the fact that in most societies, particularly Asian
societies, culture still assigns the women the primary responsibility for
household management including child and aged care. Their entry into the
labour market definitely poses a strain on the family in view of the demands
of the occupational sphere. As Hoffman (1983) puts it, "Although it has
been shown that husbands of working women are more likely to contribute
to household management, the burden falls unequally on the wives".

LACK OF RESOURCES

Another factor that limits the provision of care for the aged and the infirm is
the lack of resources which include time, money, and space (as already
discussed). When family members are too involved with their daily routines
at work, they have little time to look after or to pay more attention to their
aged parents, irrespective of where the parents stay. The situation is, of
course, worse is the parents are staying in the village far from the city. It is
only during the weekends or during public holidays, the children will have
the time to visit aged parents and to attend to their needs.

Every family has its own financial commitments. The relatively high cost of
living in the city leads to the situation where most people are not able to give
enough financial support to their parents on a regular basis. In Graham
Allan's words, "The educational careers of adolescent children might be
given priority over caring for an elderly parent; or already providing care for,
say, a disabled child would be the reason for not taking on responsibility for
the welfare of elderly parents" (1996:79). In fact, strains are imposed on
married children and they are placed in a conflicting situation between their
responsibilities to their children and those to their parents. Such difficulties
are not always admitted and are difficult to define precisely.

Only those who can afford can hire maids to specifically look after their
elderly folks, or send them to specialized centers for the infirm. However,
children feel that they have an obligation and a moral duty to support aged
parents as a way of thanking and paying back after all the parents have done
for the them over the years. Although our study shows that only 29.1
percent of the urban families mentioned that they have given financial
support to their parents, but I believe these families have done so on a
regular basis. For those who did not respond, it is probably because the
parents themselves are financially self-supporting or they have received
support from other sources, for example, from other children who are on
better economic and financial positions.

NEW VALUE ORIENTATION

Conjugal nuclear families found in the cities are both economically and
socially independent family units. Intervention from relatives and parents
from both sides are minimal. Thus, these families are more concerned about
the welfare of their immediate family members. This new value orientation
results the families being branded as selfish and less sensitive on matters that
involved wider kin circle, which include concern and attention given to aged
parents. Unless and until the parents are really infirm or critically ill do such
care and attention are given. Even so, as it was already mentioned, the
attention given is temporary, only during the time the children are back at
the family home.

Modern families place a high value on privacy. They need the freedom to do
things their own way. Encroachment into the private and personal family
affairs by any adult family member (for example by an aged parent or parent-
in-law), is something to be avoided. Sometimes, bitter conjugal querrel
erupts from direct intervention from parents into the affairs of their
childrens' families. To my mind, it is better for both parties if parents choose
stay on their own rather than to be under the same roof with their children.

New values accrued through years of urban living make a person difficult to
revert to old traditional value system of the gemeinschalf type where elements
of family cohesiveness and collective consciousness are the norms. The
degree of individualism one enjoys in the city gradually makes him feel that
the welfare of other people outside his immediate family is secondary, and
sometimes, a burden. The situation is more stringent if he or she could not
fulfill demands from wider family circles with regards to aged care. To opt
for resignation and to go back home to take care of the infirm is
unimaginable. Hence, parents have to fend for themselves until they die. It
is true as the adage says, "one parent can take care of ten children, but ten
children cannot take care of one parent".
Generation gap is another related factor that extension of care for the aged is
affected. Grandparents subscribe to a set of (traditional) values different
from those of their grandchildren who are born and raised up in the city.
Not only grandchildren feel uncomfortable with the presence of their elderly
grannies in their homes, who tend to voice out their criticisms towards their
behavior or 'misbehavior', grandparents too are not pleased with the
situations they encounter in their children's city homes. Not many will want
to prolong their stay, unless circumstances force them to. Tania Li says, "the
powerlessness and peripherality of the old people in the child's household is
an incentive for the old to continue to maintain a separate dwelling .. for as
long as the are able" (1989:60)

CONCLUSION

To sum up, social change, particularly urbanization has resulted not only to a
breakdown of the extended family system with negative effects but most
devastatingly an erosion of family values where support, care, mutual aid,
feeling of togetherness, and shared sentiments are no longer the same as they
were in the past. We cannot predict, what the situation will be in the ensuing
years. But the effort taken the government in its Vision 2020 to create a
caring society built on a stable and resilient family system is much to be
appreciated. To me, irrespective of the pace and rate of change occuring in
our midst, the family institution has to be strengthened, its values have
to preserved and instilled. The bad experience the family encounters in the
West, which leads to its "demise", is a lesson to be learnt by all members
of society who still place a high value on love, affection, companionship,
sense of self, cooperation, mutual help, family protection, and a host
of others. Aged care is still the family's main responsibility, and no other
institution can provide that except the family institution.

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