Living Conditions

Living conditions of the elderly vary tremendously in both developed and developing countries. Housing is not merely shelter, important as it is in providing protection from the elements and space for sleeping, cooking, eating, recreation and leisure. Rather, especially for many older persons, it has a long-established psychological identity with "place," relating to a broad range of personal, familial and social identities and relationships. The adequacy of housing depends not only on the comfort and amenities available in individual units, but also on the availability of a basic community infrastructure and public services. Thus, in examining the living conditions encountered by the aging as much attention needs to be given to the difficulties in gaining access to essential services and in maintaining social contacts and status within the community as to the actual physical condition of housing.

In developing countries, the growing number of aging persons appear to be experiencing a deterioration in living conditions - linked to a general lack of housing in relation to total need, substandard condition in existing housing and shortages of community social services and a public service infrastructure. Information currently available suggests that housing conditions in rural areas are generally far worse than urban areas, both in developed and developing countries. The migration of rural youth to urban industrial centers exacerbates the poor living conditions of elderly persons who remain behind— depriving them of traditional sources of social and economic support, and in many cases resulting in physical deterioration of homes. Maintaining high living conditions is also difficult in urban areas of many developing countries, where the elderly are often concentrated in slums or squatter settlements characterized by substandard housing, inadequate services and lack of sanitation. The small size of living quarters is one of the most adverse conditions connected with urban life for the elderly. Cramped flats can accommodate only nuclear families, making it necessary for older persons to maintain their own households. In many cases, this leads to a need for outside assistance to compensate for loss of traditional support from family members sharing a common shelter. While, in most developing countries, the majority of the aging still live with childrens' families, an increase in numbers of elderly persons living alone in depressed areas of cities is witnessed throughout the world. The changing composition of households is a major determinant of requirements for housing and other assistance.

In developed countries the elderly who are the most likely to have housing problems include the very old and frail, the disabled, those living in rural areas, and those living at or just above the poverty level. Because of the physical needs of many elderly, specialized housing for the elderly is a small but growing trend in developed countries. Specialized housing can be retirement communities, shared living homes, group homes, life care facilities, or sheltered housing Specialized housing can be subsidized or unsubsidized by government. The Australian experience in subsidized retirement housing was begun in the early 1950s. In 1990 approximately 8% of older Australians lived in hostels, public housing, or publicly subsidized retirement homes specifically for the aged. In Great Britain, there is both publicly and privately funded small "sheltered housing" for the elderly. Many elderly with sufficient means are moving into retirement communities or "life care" communities, run by private or religious organizations. This form of housing offers many choices in living arrangements that are suitable for both the healthy and disabled older adults.

A major difficulty facing developed nations is the ability to provide services to large numbers of elderly who are living in the community in their own homes. Some countries, such as Sweden have developed these services. Other countries are finding that the public services they currently have are not sufficient or too fragmented. In many developed countries volunteer programs are helping the elderly. For example, programs such as "Christmas in April" and "Care and Repair" make needed repairs and accommodations to the homes of poor and disabled elderly.

In Denmark a wide array of services are available to the elderly in the community, in order to allow them to "age in place". Approximately 25% of people aged 67+ in Denmark receive some type of practical assistance (e.g., shopping, laundry) and 15% receive home nursing. In addition , about 75 out of every 1,000 Danes aged 70+ receive evening home care and 32 out of every 1,000 receive nighttime home care. Other services that are readily available include day programs, rehabilitation programs, activity centers and special transport for immobilized elderly.

Portrait of a rural family in a developing country: The typical joint family in the rural areas today consists of multiple families of different generations living together. Usually there is one dominant decision maker and by tradition he runs the entire joint family according to his will. Although there is some resentment about this "dictatorial system" this system of joint family is widely prevalent and provides security to all members from birth to death. There is usually joint family land holding which is cultivated and part of the produce is consumed by the family and partly bartered for other expenses. There is a common kitchen where food is cooked for all members. Caring of elderly or other sick members and house hold chores are shared by all. This system is extremely supportive and adversity such as sickness or death or infirmity is easily handled by this system. Even though financially not well off it provides a strong social security system particularly for the elderly of today.

Portrait of an urban family in a developing country: The joint family system as described above is no longer the norm in urban areas. The widely prevalent system now is nuclear or conjugal families which consist of single families of multiple generations living together, e.g. grandparents with one son and his wife and their children living together. This system does provide care to the elderly, but it is under stress because of housing, financial and social reasons. The elderly themselves sometimes feel lonely with very little to do, residing in small urban apartments in high-rise buildings. Grandchildren, a traditional source of joy for older generations are frequently more interested in TV then in talking to their grandparents.