The Family and the Aged

It is difficult to define the concept of "family," because it has many forms of social organization and identity throughout the world, and is changing over time as well. One common attribute, however, is its role as a primary group, providing nurture, affection and social support. While the family is equated with a "place" or "household" in traditional societies, socioeconomic change has produced an extension of the family over great distances in many parts of the world.

While emotional ties and mutual support among family members remains strong in most areas of the world, it is clear that demographic change will increasingly affect the capacity of the family to continue its care-giving role. Most salient is the reduction in the birth rate and the resulting decrease in the number of children available in a family to care for aging parents. The fall in the birth rate seems to have reached its lowest point in the developed world, while beginning to accelerate in many developing countries. By the twenty-first century, it will become common for many elderly persons to have few or even no children to care for them in old age.

A second factor taxing the resources of families as care providers is the increase in numbers of the extreme aged, who may require intensive nursing and other support. While family members may wish to continue care for very elderly relatives, they will in most cases lack the skill and physical capacity to provide continuous nursing supervision. Linked to the growing prevalence of the extreme aged is the increasing probability of families encompassing four or five generations. It is no longer unusual for a 40 to 50 year old person to have a 60 to 70 year old parent and an 80 to 90 year old grandparent, in addition to adult children and even grandchildren. It becomes exceedingly difficult, if not impossible, for a middle-aged person to care for two generations of elderly relatives, in addition to carrying out the roles of parent and grandparent. The preponderance of widowed women among the elderly is another factor affecting the availability of family support. The tendency of men to marry women several years younger than themselves and the longer life expectancy of women in most areas implies that older women have a high probability of experiencing a long period of widowhood in later life. The loss of a spouse means loss of socioeconomic support and companionship and makes older women vulnerable to poverty and social isolation.

Out-migration of the youth from rural areas also acts to weaken the family support base available to elderly persons left behind. As fertility rates begin to drop in rural as well as urban areas, the problem of over-concentration of elderly persons, lacking socioeconomic support from younger family members will become even more acute in developing countries. In developing countries the elder population usually do not contribute financially to family income but contribute in other ways ranging from housekeeping to child care. Such activities free younger adult women for employment in family farms as well as paid employment. n countries where there has been a long tradition of caring for the elderly in the family, politicians are reluctant to admit or accept that this system is breaking down.

Their reluctance is based on the fact that this may be taken as a reflection on the declining moral values of the society and they would have to launch programs thereby further stretching scarce resources.

Achieving a balance between the family and substitute sources of assistance for the elderly: Given the concurrent phenomena of decreasing family size and increasing numbers of older persons, as well as other demographic and social factors affecting family structure, formal institutions have arisen to share or take over some of the families traditional responsibilities, and this trend is expected to continue. While these institutions respond to a very real need for physical care, none have proven to be acceptable as a total substitute for the family in providing psycho-social support; they may prove counterproductive, weakening roles and responsibilities still maintained by the family. Another problem is that many social policies relating to the elderly have proven dysfunctional tending to isolate older persons from their families, and in some cases to exacerbate disability. A major current policy issue is thus to find proper balance between the family and government assistance: to help the family continue to be responsive to the affective needs of its elderly members and yet to provide outside care when critically required. Clearly, social policy must take into consideration not only the needs of the aging but links between the generations.