Where to send granny? Bringing the last generation back into total society

There used to be five. Two have died in the past year, so with just three using wheelchairs and walking frames the street looks less like an archipelagic version of what Australia used to call ‘nursing homes’. That was before Covid-19 and realising the term was a lie.

In Indonesia there’s no playing with the words because the issue is only just creeping onto the public agenda and the options are few.

Where to send gran? How many rellies have extra space and the willingness and time to cope? The family which draws the short straw may be in for some difficult years.

As Angelique Chan boss of the Centre for Ageing Research and Education at Singapore’s NU, wrote in The Conversation:

‘Unlike in Western countries like Australia, traditional Asian cultures place a heavy emphasis on filial piety — the expectation children will support their parents in old age …when families were large, pension schemes unavailable and life expectancy was around 50.

‘Today, however, families in East and Southeast Asia are much smaller, divorce rates and rates of non-marriage are increasing, and fewer adult children are living with their parents.’

In Indonesia the life expectancy is now 67.3 for men and 71.4 for women. Fifty years ago it was at least ten points lower. Then the authoritarian administration of General Soeharto (who had six kids) ordered a prolonged and intensive contraception programme with the slogan Dua Anak Cukup ‘two children is enough’.

There were posters, door knocks, radio shows – even statues built of the ideal couple with the eldest always a boy – and unforeseen consequences. The Republic is now facing the elder-care crisis – not enough kids able to help.

‘Filial piety’ is a soft academic phrase for ‘doing your duty’. That usually means daughters and DILs, though many couples are now both working and in tiny houses. An alternative is to hire a live-in maid with the bill picked up by the kids, though many oldies don’t want a stranger in the house eyeing the silver and calling in boyfriends when the boss is asleep.

This is a standard horror story for Indonesian tabloids, in the same group as African gangs bashing pensioners in Melbourne parks.

The new academic term is ‘integrated care’ supporting elders to age in their own homes amongst neighbours they’ve known for decades. Six years ago, Chan produced research showing people who ‘age in place are happier and have a higher quality of life than those in institutions.’

That appears to be the case in our area, where there’s little official help. Only former permanent government employees, the military and the few who had a decent private employer scheme, get pensions. Residents contribute to a funeral fund and visits are arranged to the sick.

(Titik, a hilarious Indonesia short film of this custom is worth watching – it has English subtitles.)

In every kampong and village nearby the aged are on view, sometimes so crippled it seems they should be shut away. But their presence reminds the kids that they’re living in a total community, not one that’s been cleansed of the disfigured.

The disabled guys (no women) are pushed out of doors by seven. All are stroke victims. The next two hours are busy as neighbours head to work and the vegie salesmen, butchers, herbal remedy sellers and travelling fishmongers are most active.

So are the scavengers. They chat to the chair-ridden, pass on the gossip and do small errands. The little kids-on-wheels whiz too-and-fro, glad for an audience. Likewise, the teenage champions of the soccer field, denied grass so use asphalt expect applause when the balls get kicked between two thongs.

The raconteurs aren’t pushed by a sense of duty. The exchanges aren’t between the oldie and his bored family, or with overworked foreign staff paid to relate. They’re not sharing with same-age companions repeating similar gripes, but with fellow battlers of all ages. It helps that the culture is tolerant of tradies, drivers and salesmen taking time to shoot the breeze.

The oldies are also the security cams, calling out to strangers asking where they’re heading, shouting at the occasional speeding motorbike. In urban Australia this would get a curt or no response – in Indonesia rudeness would invite suspicion for we are all our neighbour’s keepers.

The national language is Indonesian – but it’s the secondary tongue here. First is a coarse Javanese, and anyone with a different accent gets questioned about their background.

Indonesians reckon it helps community cohesion, but Australians would find it all grossly intrusive. Though here’s a thought – not all ‘senior citizens’ want to be locked away in a gated environment with magpies trilling from lemon-scented gums and corflutes warning security patrols are active, the selling point for many ‘villages’.

Others want the sounds and smells of the cities where they worked, to see the streets, and interact with all generations. They fear being burdens, unwanted, discarded. These are the nightmares. Instead, they are told to fear intruders, so need high walls twixt them and the world.

Singapore is trialling a program called Care Close to Home, partly funded by the government’s Temasek holding company, with a reported asset base of AUD 315 billion.

Its spiel reads the ‘C2H programme supports vulnerable older adults residing in public rental flats. Localised home-based care teams coordinate and provide basic clinical, personal and psychosocial support for enrolled clients.

‘This research aims to evaluate C2H effectiveness in maintaining the intrinsic capacity and functional ability of older adults to age well in the community. Findings from the study will provide the necessary inputs for the ongoing development of current interventions.’

Australia has done well to contain the coronavirus, with (so far) 27,500 cases and 907 deaths. (Singapore (pop 5.6 million) has had 60,000 cases and 28 deaths)

.Outrageously, around 73 per cent of Australian deaths have been among the elderly infected in ‘homes’ where they were housed by their families expecting safety. The anguish being felt by relatives who organised their parents’ relocation for what seemed fine reasons at the time, must be gnawing.

Every culture handles ageing differently (ours seems to be screwing for corporate profit) but in the search for a replacement it’s worth the Royal Commission into Aged Care looking elsewhere should we get moved to retrieve the basic principle of bringing the last generation back into total society.

That’s where they are here in Indonesia. It’s called Gotong Royong, or community self-help, an ancient ethos still widely practised and much praised by governments which don’t pick up the bill. We do this too with short-term emergencies, but elder care is continuous.

Indonesian politicians and top bureaucrats can pay for home nursing which adds status to the family, so the incentive to intervene in aged care has yet to arrive.

That’s not the Ozzie way. We pay high taxes (Indonesians don’t) and governments have responsibilities which can’t be shunted onto others. Yet that’s what’s happening.

(Disclosure of insights: My widowed MIL, 82, is losing muscle control; though still mentally alert she needs constant attention.Two of her six children live under the same ill-maintained roof. The others cook special meals and wash her linen. It’s a big op which may run for many years putting brakes on others’ plans, though commonplace in this society.).

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Duncan Graham has been a journalist for more than 40 years in print, radio and TV. He is the author of People Next Door (UWA Press) and winner of the Walkley Award and Human Rights awards. He is now writing for the English language media in Indonesia from within Indonesia.

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