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On Family and Caring for the Ageing

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John E. Carey
We recently advocated that Congress might consider less severe cuts to our research funding devoted to understanding and solving illnesses commonly associated with the elderly, such as Alzheimer's ("Staggering Costs of Alzheimer's Disease," September 21, 2006:

One of our very well educated younger Americans (she said she was in graduate school) wrote to lecture me that Alzheimer's wasn't even a disease: it was just old age and therefore deserved no research funding of any kind. Ever.

I wrote back wishing her a very long life lived under the current, deteriorating American medical system. With no federal funding.

Just kidding.

One of the unique perspectives I may have on the American "system" of caring for the ageing comes from my marriage: my wife and more than half my family is Vietnamese.

According to John Knodel and Nibhon Debavalya, authors of "Social and Economic Support Systems for the Elderly in Asia," "In the case of most Asian countries, the family is the traditional social institution for the care of the elderly who live and work with their children."

In much of Asia, though certainly not everywhere, the members of the ageing population, compared to ageing Americans, tend to have more roles and functions in the family (cooking, doing laundry, child rearing), a better health situation, and a longer life.
Certainly in much of Asia, and by no means is this true of everyone everywhere, the ageing are accepted members of the family. Perhaps the ageing are even revered with a sort of special status. They generally live happier and longer lives.

In the United States, as far as I have been able to observe, older citizens are more likely cast aside, put into assisted living, confined to nursing homes or otherwise excluded from the homes of their children and their grandchildren.

Asian-Americans face a difficult situation as they age.

First generation Asian families to America have a tendency to, at least in large measure, embrace the traditions and values of "the old country." But once the second generation reaches adult age, these Asian-Americans have just about fully adopted the American way of treating the elderly.

This puts an added burden on civic and public ageing facilities and services.

A few years ago, Michael Rabin the Deputy Commissioner of the Department for the Aging in New York wrote, "Yet another sign of the changing socioeconomic realities for these families is the hundreds of Asian elderly who daily attend their neighborhood senior centers. Financed by the Department for the Aging, these centers serve more than 400,000 Asian-style meals a year, including 30,000 delivered to those who are homebound. Like most members of the city's 335 senior centers, Asian elderly don't come just for the food. They come to meet with their friends, play mah-jongg, take part in Chinese painting classes, t'ai chi and many other activities. It is these special places that prevent isolation and help older people maintain a sense of well-being and independence."

While this is commendable, there is a lot of benefit from having the ageing family member, well, in the family! According to Knodel and Debavalya, "The elderly not only receive support and services from others but also provide them. Understanding their contributions to their families is important in assessing and enhancing their role in the context of social and economic change."

And the contributions both from younger to older and older to younger are not measurable merely in terms of health care, laundry and cooked rice.

There is a deeply psychological benefits to all generations.

UCLA Professor and syndicated columnist Tom Plate wrote in June 2004, "Because people there can live for a long time -- due to diet, less urbanization, the deep consolation of Asian religions, tender family care, who knows? -- older people are sometimes afforded special status. The reasoning goes like this: If they have lived so long, they must possess some special life force. Suppose that secret spirit of healthy longevity can be transmitted and absorbed."

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John E. Carey is the former president of International Defense Consultants, Inc.
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