Asia-Pacific E-Journal of Health Social Science https://sites.google.com/site/asiapacificejournalofhss/. June 2013. Volume 2, Number 1. All rights reserved.

ISSN 2244-0240

Journey

Growing Old Gracefully: A Filipino Familys Grandmothers Story

Yellowbelle Del Mundo Duaqui Behavioral Sciences Department, De La Salle University, Manila, the Philippines, yellowbelle.duaqui@dlsu.edu.ph

Based on The Expanded Senior Citizens Act of 2010 or Republic Act No. 9994, the elderly is defined in the Philippines as persons 60 years old and above. Between 1970 and 2010, the elderly population has been increasing at 3.4% annually (Albert, 2012). At present, there are 6.4 million elderly Filipinos comprising 6.9% of the total population. By 2016, the number is projected to grow to 7.8% (Virola, 2011). Like many countries all over the world, the Philippines has an aging population caused by decreases in its fertility and infant and child mortality rates and a general improvement in the health levels of its population (Cruz, 2007). While the Western world and the richer countries of the Asian region like Japan, Singapore and South Korea have an institutionalized care and support system for their elderly populations, the Philippines has retained to this day its family-based tradition of caring for its elderly. Across several generations, the Filipino family has systematically allocated time, money and energy to safeguard the quality of life of its elderly. Abejo (2004) pointed out that the Philippines has yet to institute a well-developed social security system for the elderly. The lack of such a system thus forces the Filipino elderly to depend on their children or co-resident kin for various forms of support. The high dependency ratio in the Philippines (i.e., economically productive persons have a large number of young dependents) also renders the Filipinos vulnerable at older ages, due to their inability to save money before they retire. Mapa et al (2010), using household data from the Family Income and Expenditure Survey, reported that the number of young dependents in elderly-headed households reduces the saving rates of the household. The socio-economic analysis of the Filipino elderly situation in the country, however, could not fully account for the nuances of elderly care, especially that it involves dyadic relationships between the caregivers and elderly persons, and family dynamics. My familys experience of caring for an elderly member as narrated in this paper hopes to offer insights on the family-based elderly care management in the Philippines. I am a woman, by the way. Thin, petite and fragile-looking, my 91-year old Filipino-Chinese grandmother, Lola Alice would not, at first, strike you as somebody who has remained strong and whose memories of the past have remained intact. In her animated moments, she can even tell you stories about her childhood. Except for certain occasions when she

would repeatedly tell the same stories to the same people (e.g., grandchildren, neighbors and house help), she is generally healthyemotionally, psychologically, and even physically. Sometimes, she would even burst into singing a kundiman (Tagalog love song) or a Visayan song, which indicates that she is happy. But Lola Alices maintenance has not been left to chance; elderly care in our household is a unified family effort. By the time she reached 88 years old, she began to become more dependent on other peoples assistance. In 2009, a serious incident diminishing her physical capacity occurred after she accidentally slipped on her way to the washroom. My mother found her slumped on the floor, unable to move her limbs and writhing in pain as her hip and legs hit the floor during the fall. It was fortunate that she was able to cushion her head with her hands. This induced a nearly year-long bed-ridden condition for my Lola and also placed my mother to be at her bedside almost 24/7. Fortunately, my mother worked as a senior management team member, and as such, her flexible working hours enabled her to attend to my Lola and her needs on almost a full-time basis. As I was away from my family at the time (i.e., I was finishing my masters degree in Japan), my mother relied on my younger brother for further assistance in caring for my grandmother. In my absence, my brother had to play the role of a surrogate daughter/granddaughter. In a way, Lola Alice is luckier than her American counterparts, due to the availability of my mother (and brother) to provide her a personalized care. In the United States, as a result of the dual-focus workforce and the aging population, the time spent by employees caring for an elderly has become a workplace issue. Elderly care has been associated with stress, depression and burn-out, and subsequently, with absenteeism and workplace turn-over among working caregivers (Rose, 2006). Employees with elderly care responsibilities are more overworked compared with employees who do not have similar duties (Families and Work Institute, 2004). Only 25% of workplaces in the US offer elderly care benefits to their employees. Elderly care can take a toll on caregivers. If it is any indication, after a year of frequent sleeplessness and fatigue, my mothers health deteriorated.

Asia-Pacific E-Journal of Health Social Science: Growing Old Gracefully: A Filipino Familys Grandmothers Story

My mother naturally sought professionalized medical care for Lola Alice. After a long and arduous search for a good orthopedic doctor, my mother located one from a local private hospital. As a consequence of the medical assistance she received, my Lolas condition saw some improvement. But where the doctors work ends, the function of the caregiver at home begins. At first, my mother admits to performing caregiving tasks quite clumsily. My mothers best friend, also a medical doctor who knew about the situation, henceforth informally trained her and my brother on the fundamentals of care giving for the elderly. This includes feeding, bathing, changing clothes and adult diapers, administering the bedpan, sitting, and skin care management for the elderly. The medical doctor also suggested acquiring several items to improve my Lolas well-being: a wheel chair, a cane, a toilet chair, and an egg-tray bed. A beautician eventually took on the task of maintaining my grandmothers skin care regimen. A trained physical therapist regularly came to teach my mother how to provide assistance to an elderly who is bed-ridden. The driver has also learned how to assist (even carry) my grandmother during out-of-town trips. The house help, meanwhile, does the laundry for my grandmother. Following the medical doctors advice, all members of the family had also been trained how to feed my grandmother a cup of an adult nutritional formula at various times of the day. There are many instances when my grandmother would not have the appetite for rice and traditional Filipino food (e.g., soup or vegetables); the formula is a good source of alternative nutrition for her. My grandmother generally thrives on soft biscuits, cupcakes, and Chinese dim sum. She also drinks alkaline water to prevent loose bowel movement. Occasional dining at Chinese restaurants also helps improve her appetite. For my grandmothers emotional well-being, we schedule outof-town trips, bring her to clan reunions, and invite her grandchildren to visit her in the house regularly. The reassuring presence of my mother, who serves as her chief caregiver, is the main source of emotional support. It is best that elderly people are left alone when they need rest, but they also need to be surrounded by people during their waking time. Social interaction keeps them happy and makes them feel loved. My grandmother, who spends most of her day doing what she loves most (sleeping), can only demand a small portion of peoples time. There are times when she admits to feeling useless. After all, she was a busy body during her youth. What we do to make her feel productive is to give her some simple tasks (e.g., folding laundered clothes). Any references to her bowel movement or her lack of appetite would readily upset her; thus, we avoid mentioning them. As a devout Catholic, we also know that Lola Alices inability to attend Sunday masses would somehow affect her spiritually. So we arrange for the lay ministers to come to our house on a weekly basis in order to administer the Sacrament of the Holy Eucharist to my grandmother. After one year, my grandmothers eventual recovery from her bed-ridden state and the restoration of her health has been a story that continues to inspire many people around our community. My Lolas recovery is really an outcome of my mothers and our familys efforts. The success of elderly care in the Philippines, as exemplified by Lola Alices case, requires a consolidated family effort and a high level of commitment by family members to sustain the maintenance 2

of the elderly. The challenges for elderly care in the Philippines are daunting, given the paucity of the formal welfare system that will address the unique needs of elder persons, but the empowerment of the caregiver through proper training can become a good starting point. REFERENCES Abejo, S. (2004). Living arrangements of the elderly in the Philippines. Retrieved from http://www.nscb.gov.ph/ncs/9thncs/ papers/ population_LivingArrangements.pdf. Albert, J. R. G. (2012). Understanding changes in the Philippine population. Retrieved from http://www.nscb.gov.ph/beyond thenumbers/2012/11162012_jrga_po. Cruz, G.T. (2007). Active life expectancy among Filipino older people. Retrieved from http://www.nscb.gov.ph/ncs/10thNCS/ papers/invited%20papers/ips-26/ips26-01.pdf. Families and Work Institute. (2004). Overwork in America: When the way we work becomes too much. Retrieved from www. familiesandwork.org. Mapa, D.S., Davila, M.L., & Albis, M.L.F. (2010). Getting old before getting rich: The economic state of the elderly in the Philippines. Retrieved from http://www.nscb.gov.ph/ncs/ 11thNCS/papers/invited%20papers/ips23/03_Getting% 20Old%20Before%20Getting%20Rich_The%20Economic% 20State%20of%20the%20Elderly%20in%20the%20Philippines. pdf. Rose, K. (2006). Elder care: A responsibility that requires a collaborative effort. WorldatWork Journal, 15 (2), 61-69. Virola, R. (2011). Seniors moments. Retrieved from http:// www. nscb.gov.ph/headlines/StatsSpeak/2011/071111_rav. asp.

DID YOU KNOW?

Key facts on Falls
Falls are the second leading cause of accidental or unintentional injury deaths worldwide. Each year an estimated 424 000 individuals die from falls globally of which over 80% are in low- and middle-income countries. Adults older than 65 suffer the greatest number of fatal falls. 37.3 million falls that are severe enough to require medical attention, occur each year. Prevention strategies should emphasize education, training, creating safer environments, prioritizing fallrelated research and establishing effective policies to reduce risk. A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Fall-related injuries may be fatal or nonfatal1 though most are non-fatal. Quoted from: WHO

http://www.who.int/mediacentre/factsheets/fs344/e n/index.html