Nobaya Ahmad
Dept. of Social and Development Sciences Faculty of Human Ecology
University Putra Malaysia [email protected]
ABSTRACT
Elderly care giving has always been an issue in countries that is becoming an aged society.
However, caregiving has always been the traditional and cultural role of the women specifically the daughters. Many studies locally and globally, have shown that when it comes to care giving, women have been playing an important role in ensuring the welfare of the children, family and elderly is taken care of. The role of caregiving has always been associated with the nurturing role of women. With more women in the workforce in recent times, the role of caregiving for the elderly has taken a turn in the form of services provided by the public and private sector like nursing and elderly residential homes. Issues like the lack of such homes to provide care and the role of other members of the family in the care of the elderly often arise. Contrary to the views in the western society, sending the elderly to be care for in nursing homes and residential care is still not widely accepted in the culture of the society in the east. Hence, the issue of who should care for the elderly is still a matter of concern for the Asian community. What role does the other members of the family play in care giving to the elderly? In Islam, the role of caring for the elderly is clearly specified in many Surahs and the role as describe in the surah does not differentiate between men or women in terms of care giving for the elderly.Hence, the aim of the paper is to highlight issues on caregiving as practiced in many communities, east and west, and discuss the role of men and women in caregiving for the elderly as outlined in Islam.
Keywords: Elderly, Caregivers, Aged society, Role in caregiving
INTRODUCTION
There is an old Malay proverb that can be translated as “a mother can take care of 10 children but 10 children cannot take care of one mother (seorang ibu boleh menjaga sepuluh orang anak tetapi seorang anak tidak boleh menjaga seorang ibu)”. This proverb in a nutshell describes the issue of elderly caregiving in the current era. Elderly caregiving is a challenging role that is played by many spouses, children and family members at a time when life expectancy of many societies became longer. Caregiving of the elderly in the current situation has also given rise to the sandwiched generation, that is, the generation that is trapped into caring for the elderly as well as caring for the children and sometimes grandchildren. As people lived longer, it is not uncommon to find four generations in a household die (great) grandparents, parents, children and grandchildren. Caring for the elderly will not pose a problem if the elderly are generally healthy, but when the elderly becomes frail and sickly, taking care of them can provide challenges for the care givers, especially if the caregivers also have other matters to take care of, like their own family or their career.
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Traditionally, and in many societies, care giving, including for the elderly has been the role of the female members of the family. This is true, even for the western societies where the women play more roles in caring for the elderly. It was not a challenge for women in traditional societies to play the role of the primary caregiver, but as more and more women join the formal workforce, the role of care giving became an additional role to an already established role of being a wife, mother, daughter, daughter in law and now employee.
According to a study published by National Alliance for Caregiving United States (2009):
The role of women in care giving has been associated with their nurturing role. An estimated 66% of caregivers are female [Updated February 2015]
The average caregiver is a 49 year old woman, caring for her 60 year old mother who does not live with her. She is married and employed. [Updated February 2015]
Although men also provide assistance, female caregivers may spend as much as 50%
more time providing care than male caregivers.
Hence, it cannot be denied that the care giving especially amongst the women, is an important and challenging role. In Malaysia, more than 50% of the women are in the workforce. The female labour participation rate in Malaysia was 52.4% in 2013, which means, for every 100 women, 52 were in the labour force (Statistics Department, 2013). As workforce participation increases, caregiving could pose even greater financial challenges for many women workers, due mostly to lost wages from reduced work hours, time out of the workforce, family leave or early retirement.
RESULTS AND DISCUSSIONS
A. Caregiving
Who are the family care givers? Information retrieved from the American Psychological Association bulletin indicated that according to estimates from the National Alliance for Caregiving, during the past year, 65.7 million Americans (or 29 percent of the adult U.S.
adult population involving 31 percent of all U.S. households) served as family caregivers for an ill or disabled relative. Estimates also suggest that the majority of caregivers are female.
The percentage of family or informal caregivers who are women, range from 53 to 68 percent, according to the Family Caregiver Alliance. While men also provide assistance, female caregivers tend to spend more time providing care than male caregivers (21.9 versus 17.4 hours per week). Further, women are likely to assist with more difficult caregiving tasks, such as toileting and bathing, while men are more likely to assist with finances or arrange for other care (Family Caregiver Alliance, 2012). Many caregivers of older people are themselves older adults. Of those caring for someone aged 65 or older, the average age of caregivers is 63, with a third of these caregivers in fair to poor health themselves (Administration on Aging, 2004).
Caregiving is becoming more important due to the longer lifespan of the population. Many countries in the world are becoming aged society where more than 10% of the population are above 60 years old. Even in ASEAN, it is projected that Brunei Darussalam, Malaysia, Singapore, Philippines, Thailand, Vietnam and Indonesia will become aged society by 2025.
With an increase in the number of aging population, the demand for care will also increase.
At the moment, most of the caregiving for the elderly, especially among those who are no longer active are taken care of by the public or private funded nursing/residential homes and families. Demographically, a women lives longer than man, and this will give rise to more
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elderly women at the top of the age pyramid. Women are generally less educated and more economically dependent on the spouses and being alone at the old age will require care by the family members to ensure that their welfare is taken care of.
In a modern and urbanized world, the family’s ability to take care of the elders in the family is often challenged by the demands for better economic stability. The shift from extended family system to a nuclear form and changes in terms of residential location often results in the aged living apart from the children. A weakening family bond can have serious consequences of care giving of the elderly. One of the priority areas in the Madrid Plan of Action on Ageing is to ensure that the family plays an important role in creating an enabling and supportive environment for the elderly. Hence, strengthening the family relationships is important as an informal support to elderly caregiving.
B. Role of Children in Care Giving in Islam
Is there a gender differences in terms of caregiving? Many of the studies that were done on caregiving indicated that female members of the families tend to become primary care givers compared to male. This is true for both western and eastern societies. All societies promote respect for the elders as a core value amongst family members. In many societies, for example, the Confusion teaching of ‘filial piety’ prioritizes the family unit and values elders with the utmost respect. According to Wagstaff (2013) “Elderly Rights Law” in China states that adult children "should never neglect or snub elderly people" and should visit their parents
"often," even if they live far away.
Karina Martinez-Carter in The Week (2013) wrote about how different cultures treated their elderly. According to her, Koreans not only respect the elderly, but they also celebrate them.
For Koreans, the 60th and 70th birthdays are prominent life events, which are commemorated with large-scale family parties and feasts. As in Chinese culture, the universal expectation in Korea is that roles reverse once parents’ age, and that it is an adult child's duty — and an honourable one at that — to care for his or her parents. Like the Chinese and the Koreans, the Japanese prize filial piety and expect children to dutifully tend to their parents. However, the case is not so in Western society whereWestern cultures tend to be youth-centric, emphasizing attributes like individualism and independence. This relates back to the Protestant work ethic, which ties an individual's value to his or her ability to work — something that diminishes in old age. Anthropologist Jared Diamond, who has studied the treatment of the elderly across cultures, has said the geriatric in countries like the U.K. and U.S. live "lonely lives separated from their children and lifelong friends." As their health deteriorates, the elderly in these cultures often move to retirement communities, assisted living facilities, and nursing homes.
However, according to Martinez-Carter, France did, however, pass a similar decree in 2004 (Article 207 of the Civil Code) requiring its citizens to keep in touch with their geriatric parents. It was only enacted following two disturbing events, though: One was the publication of statistics revealing France had the highest rate of pensioner suicides in Europe, and the other was the aftermath of a heat wave that killed 15,000 people — most of them elderly, and many of whom had been dead for weeks before they were found.
The culture in the Mediterranean and Latin countries however promotes strong family values where family is priority. The term ‘la famiglia’ is very common in usage amongst the Italians and the culture of Italian Mafia can be attached to strong family relationship. In both cultures, it's common for multiple generations to live under one roof, (à la My Big Fat Greek Wedding)
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sharing a home and all the duties that come with maintaining one. In the contemporary iteration of this living arrangement, the oldest generation often is relied on to assist with caring for the youngest, while the breadwinners labour outside the home. As such, the aged remain thoroughly integrated well into their last days.
Few articles discussed in depth about the role of male and female in care giving. How does Islam addresses the role of caregiving for the elderly and is there a gender perspective about it? Islam addresses the role of care giving for the elderly in a multitude of perspectives.
Caring for the elderly has been written in many Surahs of the Quran as well as Hadiths. It has also been iterated that a person's duty towards his parents comes second only to his duty towards Allah. For example, in Surah Al Isra’, (the interpretation of the meaning) Allah swt says:
“Your Lord has commanded that you worship none but Him, and that you be kind to your parents. If one or both of them reach old age with you, do not say to them a word of disrespect, or scold them, but say a generous word to them. And act humbly to them in mercy, and say, ‘My Lord, have mercy on them, since they cared for me when I was small” (Al Isra’ 17: 23-24).”
In Luqman (31:14) (an interpretation of the surah) Allah says:
“And We have enjoined on man (to be dutiful and good) to his parents. His mother bore him in weakness and hardship upon weakness and hardship, and his weaning is in two years give thanks to Me and to your parents, unto Me is the final destination (Luqman 13:14)”
The emphasis on caring for the elderly was also stated in hadiths for example, a Hadith narrated by Al Tirmidhi stated that “The Prophet (peace and blessings be upon him) said,
"He is not of us who does not have mercy on young children, nor honour the elderly" and another narrated by Abdullah ibn Amr ibn al-'As: “The Prophet said: Those who do not show mercy to our young ones and do not realize the right of our elders are not from us”(Sunan Abu Dawud).
There are many more examples of how Muslims should treat their elderly in the Surahs and Hadiths. According to an article byArafa and El Samanin Marq Elder’s Advisor (2012), the elderly has several rights based on the Islamic law as prescribed in the Quran and sunnah that is rights to equality, rights to care, rights of parents after death, financial rights and inheritance and rights of older neighbours, friends and other companions. However, in all the teachings, there was no indication that care giving is the role of the female/daughters only.
Hence, the role of care giving for the elderly should be the responsibilities of both sons and daughters. Therefore, the issue of whether the sons or daughters should be more responsible to care for the elderly has to be understood also in line with the Islamic law of inheritance.
In line with the Islamic law of inheritance, sons get the bigger share of the inheritance based on the faraid. The role of the Faraid is to provide a system or method of distribution of one’s assets after death in accordance with Islamic principles. The principles are laid in the Quran in Chapter 4 Surah Al Nisa’.
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The table below provides a summary of distribution of inheritance based on the Faraid.
TABLE 1 GENERAL RULES OF DISTRIBUTION AMONGST CERTAIN SPECIFIED HEIRS BASED ON SIMPLE CASES
Heirs Husband
If there is no child or grandchild surviving the deceased 1/2 If there is a surviving child or grandchild of deceased 1/4
Wife
If there is no child or grandchild surviving the deceased 1/4 If there is a surviving child or grandchild of deceased 1/8
Son
If there is no daughter Residuary
If there is a daughter (he shares with his sister, but is entitled to 2 shares for
every share given to her) Residuary
Daughter
If sole daughter 1/2
If 2 or more daughters (the daughters portion is shared equally among them) 2/3 If there is a son, (she shares with her brother, but is entitled to 1 share for
every 2 shares given to him) Residuary
Father
If there is a child or grandchild surviving the deceased 1/6 If there is no child or grandchild surviving the deceased Residuary
Mother 1/6
Paternal Grandmother (her portion is shared with maternal grandmother) 1/6
If Mother or Father survives Nil
Paternal Grandfather
If no father, child or grandchild survives Residuary
If son or grandson survives 1/6
If father survives Nil
Maternal Grandmother (her portion is shared with paternal grandmother) 1/6
If Mother survives Nil
145 Brother
If father, son or grandson survives Nil
If no father, son or grandchild survives Residuary
Sister
If father, son or grandson survives Nil
If sole sister 1/2
If 2 or more sisters (they share equally) 2/3
If Brother survives (they share 2:1 with Brother) Residuary http://www.lawsociety.org.sg
While the issue of the Faraid is not under consideration in this article, the relationship to the role of the son in care giving is customary to be associated to the law of inheritance. Since the son will be getting a bigger share (twice to the daughter), then it is only fair that the primary care giving role to be undertaken by the sons in a Muslim family. However, for the sons, there is a need to be in consultation with his wives in terms of the role of primary care givers since it is most likely that the wives will also be playing the role of care givers to her own set of parents if she has no other siblings to share the role with.
In this sense, the nature of relationship between the daughters in law/sons in laws and the parents in law as a social relationship will determine if care giving can be accepted by the sons/daughters. In reality, this will not pose a problem if all parties understand their role towards the elderly. As it is, in Malaysia, most of the primary care givers are assumed by daughters rather than sons, simply because most parents prefer to be taken care of by their daughters. This is where the dilemma arises, especially, if the women is not financially independent and has to rely on the husbands for financial support for the family and the parents. For working women, the stress of having to manage many roles may create problems in playing the role of primary care givers.
The dilemma of women in care giving role in Islam can also be attributed to the role of the man as the head of the family.A man's major responsibilities lie outside the family. He is to support the family economically and materially, he has to look after the relations of the family with the rest of the society, economy and policy and he has to take care of the demands of internal discipline within the family. A woman's major responsibilities lie within the family. Here too, the eldest woman is regarded as the centre of the family organisation but within each circle and fold the relative central position is enjoyed by that woman who constitutes its core. A spectrum of mutual rights and responsibilities has been evolved in such a way that balanced relationships are developed between all (Kurshid Ahmad, 1980).
In a previous study on social support amongst the elderly conducted by Asnarulkhadi et al (2009), it was found that there are many kinds of support required by the elderly parents. The most important support is the emotional support. Financial support is also important especially for the lower income group. In many cases, the elderly parents preferred to be cared for by the daughters. Hence, it is important for families to share the responsibilities of caring for the elderly as stated by the Quran and Hadith. Sending parents to be cared for in residential or nursing homes are still a taboo although Islamic forms of residential home are
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becoming a popular options for retirees and elderly. Mostly, those who opt for this kind of residential homes are those financially and physically independent. Those who are frail and sick still require home based and full time care givers support. Siblings should be prepared to shoulder the responsibility together and the sons should be ready to provide other means of support like financial if they are not able to shoulder the responsibility of becoming primary care givers.
CONCLUSION
The paper highlights a brief overview of important issues in care giving for the elderly especially in Islam. While there may be many social support services provided by the Government and private sectors to ensure the aged are taken care of, the role and responsibility of the family especially the children is still important in every communities and culture. Going back to the basic of what family is, should be the core of elderly care giving.
Every child irrespective of whether there are sons or daughters hasa role to play in giving support to the elderly parents, whether it is financial, social or emotional support.
Strengthening family values and teaching the young the qualities of filial piety and respecting the elders should be enhanced especially in the current era where priorities in life takes a shift from family to other material values.Elderly care giving should not be considered as a chore or burden but should be considered as an honourable role by Muslims and non-Muslim alike.
To quote Rosalyn Carter:
“There are only four kinds of people in the world.
Those who have been caregivers.
Those who are currently caregivers.
Those who will be caregivers, and those who will need a caregiver.”
One day, we will all grow old and become dependent on other people, too. As the English says “as you sow, so shall you reap” or law of the Karma states that “what goes around, comes around”. Hence, if you want to be treated well by your children later, it is only right that you treat your elders well now. Therefore, the dependency on external support for elderly care giving should just become a respite or complimenting rather than the main forms of support for elderly care giving.
ACKNOWLEDGEMENT
The author gratefully acknowledged the contribution of University Putra Malaysia and University Kebangsaan Malaysia that leads to the publication of the article.