Australia could take a leaf from Indonesia’s personalised approach to aged care

Mar 9, 2021

Our street in Indonesia has 70 households. Many are mixed-generation families. With few nursing homes or retirement villages, and those being far away, families have two options: The kids do the caring or employ a carer. Either way, Grandpa or Grandma stays home.

Sawojajar is eight degrees under the Equator and a suburb of Malang, an East Java hilltown nudging one million. Days start with the 4:15 am call to prayer. An hour later as the sun crests the mountains, the street’s five elderly and infirm men are wheeled out of the houses they once lorded and sometimes shuffled into plastic chairs.

There’s no sense of abandonment, more a welcome back. Parked in the shade of mango trees the old fellows expect to finish their days where they’ve lived among familiar faces, sounds, sights and smells. Here they’re obvious to all, spectators of the daily parade yet also participants.

With no public parks or pavement, the bitumen is the community room, an oval, a market, an open-air hall, a thoroughfare. There’s much to hear and see, and not one event has been organized by a social welfare consultant.

A quarter of Australians are reported to be lonely. No similar studies in Indonesia where mental health isn’t a front-page issue, but chances are there’d be only a few suffering solitudes – and certainly not in this street.

Indonesians engage easily with strangers. The watchers outside their wrought-iron fences advise reversing drivers of hazards, direct strangers to the right address, hold parcels for absent residents and act as human CCTVs.

The steps into familiarity start with asking where the visitor is going, leading to questions about the family’s origins, age, the number of children and religion. If privacy is precious, don’t retire in Indonesia.

This isn’t an attractive street, just rising above the average, middling middle class, homes mostly owned by the occupiers. The houses were badly built on a rice field in the 1990s so there’s much repairing and expanding. Tradies weld, mix concrete and cut timber on the road. Workers are always watchable and cheerfully accept unsought advice.

The elderly and their live-in helpers (A$150 a month) are left behind when Mums and Dads head to work, shuffle around in shapeless housecoats caring little about their appearance, for the black-top is their backyard. They’ve already done the laundry; the clothes drying on the fence reveal who sports G-strings and fancy bras.

Now the plague has closed classrooms the kids have turned the street into a sports centre. They practise pushbike stunts, whack shuttlecocks, kick barefoot goals marked by flip-flops on the asphalt. The granddads keep score and shout tactics.

Health is an issue for the elderly so there’s Ibu Jamu carrying a basket of bottles on her head, stirring a secret herbal mix to guarantee longevity and fix most moans – a sore back, inflamed throat, headaches, and every ailment in between. Maybe even Covid-19.

She blends her patient’s personal supplement, revealing juicy news of others’ complaints while the customer drains the glass. There’s a free health clinic a couple of km away, but Ibu Jamu is alongside.

So is a mobile shop. A middle-aged woman pushes a four-wheel cart stocked with household necessities from soap powder to salt. Dad can get his ciggies or the Jawa Pos without asking anyone to do errands.

Raps on a hollow log announce the bakso (meatball soup), cook. He’ll boil a breakfast broth on his kaki Lima (five-feet) pushcart and serve the retirees where they sit.

Hawkers’ barrows are everyone’s news hub, the place to update on disputes and dramas, to plug into sagas of straying husbands, barren wives and wayward teens. The oldies are always in the loop, in the rhythm of life.

There are no government home care packages. Only former public servants, the military and employees of big corporations get pensions.

A 2020 report by a team from Yogyakarta’s Gadjah Mada University claims only the government and a few non-profits provide nursing home care: “However, the term ‘nursing home’ has been embedded in Indonesian society as a place to live for elderly who are poor, are neglected, and do not have families, so it shows unfavourable stigma.”

Almost two-thirds of Indonesian men smoke, with lung diseases taking an estimated half a million lives a year. That was before Covid-19. Four heart attack victims (three were heavy users) have recovered some speech. One seems to have dementia.

When it gets too hot or wet (we’re eight degrees under the Equator) the seniors get pushed or steered indoors, hoping they’ll make it to the morrow. World Bank stats show Indonesian women’s life expectancy is 74 years and men’s 69.4. Add a decade for the Australian figures.

Departure day comes with a black cross on a white flag. All go to the house, discreetly leave an envelope, comment about the open-coffined corpse on a trestle standing in ant repellant talc, praying together whatever the family’s faith.

If Muslim – and that’s almost all residents – the deceased stays only till washed and relatives have visited. Then it’s whisked in an ambulance to the nearest graveyard. There are seven within a couple of kilometres, forests of frangipani.

The last bloke drew his last breath before 5 am and was in the ground by 10.

What did he die from? Only a foreigner would ask such a silly question: Allah called. It is more important to inquire about the time of passing and final words, because these can be interpreted to have special meanings.

This is neither Struggle Street nor Pleasantville. There’s nothing romantic or admirable about how the neighbourhood runs – it’s standard and the elderly don’t get shielded from the realities.

There are a few snots. Parking sometimes causes mild friction. Real or imagined insults get stored and not all have a use-by date. The idle remember family scandals and religious conversions from the last century and like to update newcomers.

Semi-feral felines rip apart plastic rubbish bags for chicken bones. Scrumpers get lured by the mango trees, so some have been felled angering greenies. Unswept leaves irritate the fastidious. Yet it’s rare to encounter threats to move.

The Great Australian Fear of millions of Asians fleeing their ghettos and swamping the empty land below does not apply to the Javanese; though their island is already one of the world’s most overpacked, they’re homebodies.

Sawojajar is where they’ve lived for decades and where they’ll die, not grouped apart by age or disability but inseparable from the newborns, the itinerant traders, the kids growing up, the passers-by, the riches and routines, sad times and jolly events. They’re integrated.

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