Aging in Community Project in Sri Lanka

Buddhism philosophy heavily influences on current caregiving situation in Sri Lanka. Caring for older parents is one of the most important duties as human being in this philosophy. Not only children, but also relatives provide care for elders. Neighbors do not provide direct care, however, they do involve in other types of support, such as bringing foods, helping house keeping activities, or visiting elders to be a company.

Traditionally, youngest son takes care of parents’ house, but caregiving responsibility would be shared by other member of family as well. If children migrated into urban setting and financially stable, they bring their parents to their houses to care for them. This situation occurs due to the limitation of job opportunities for young people. Once people get a job, they have to keep it for a long time because there may not be another job opportunity available anywhere in Sri Lanka . The people do not have enough resources or stable job, they move back to rural area to care for their parents. If this arrangement does not work out, elders move into aged care homes which are usually caring for elderly women without any family or relatives.

Because Sri Lanka provided free education and free healthcare for over 60 years, elderly population in this country are much healthier and more educated. These educated baby boomers are eager to provide opportunities for better education and job for their children. As a result, they do not expect their children to take care of them in the same way that they did to parents, because they do not want to be a burden for their children. Many of the middle class baby boomers are more acceptable to the idea of moving to aged care setting when they need care. In fact, some social policy analysts and government official mentioned that they would like to encourage the development of long term care industry for elders because of the rapid growth of elderly population in next 30 years. I was a bit surprised to learn that they did not seem to worry about the potential consequences that may be caused by the institutional care.

It is important to note that the information above may only be applicable for the people are in the middle class. Low-income families still rely so much on social capital among family, friends, and neighbors. In the last several days, I have been hearing the concept of “social class/status” so many times from various people. This issue needs more investigation to since “living with similar background together, yet well-mixed interactions” seems to be a desirable/comfortable condition for the people in Sri Lanka .

Why? Why is it so hard for people to move away from institutional care?

I have been quite impressed by the high standard of human value and generosity among Sri Lankan since I arrived here. Today, however, I was simply shocked to discover that the “culture of institution” rooted deeply in this country. I am sure that the people who are involved in the culture change movement would be so frustrated to hear the term “inmates” when people refer elders in long term care settings. The individuals, whom I was talking this afternoon, kept using the term “inmates,” which absolutely made me crazy!!! I repeated to refer them back as “elders” for many times, however, they did not seem to sense the implicit way of telling my discomfort. So, I finally told staff and owner of the organization that “I would appreciate if you could call these elders as “elders” rather than “inmates”, because inmates sound as if they are prisoners.” Some people thought my comment being offensive, because they were proud of providing a “good enough care” for elders who are in need of care.

There is a clear social status in the society of Sri Lanka . There is countless number of people including children begging foods on streets. The people seem to accept this situation and live their lives without questioning serious about this situation. I felt that people are eager to share whatever they have to help others. The attitude toward age care is also based on their sharing culture. The elders who are living in age care settings are mostly women who do not have any family or relatives. Some are elderly homeless people from street. Charity organization operates these settings with donation from general public or NGO such as Helpage. The residents of the facilities pay as much as they can afford to give to the organization. People from surrounding community sometimes donate money, but most of the time, serving foods for elders. The donors feel that bringing the home cooked meals for the elders will give opportunities for elders to enjoy variety of home-cooked meals. It seems that many practice this way of sharing at least once a month.

When we visited an aged care for 27 “elder orphans,” I could not hide my sad feeling. There were four beds in a each room, and one shared bathroom for all of the residents, except for the bedridden residents. Elders seem to be relatively satisfied with their living environment, and staff members were proud of their operation. In fact, all of the 6 staff members live in this facility. Their rooms are located right next to residents room and the quality of the room was as same as other residents’ rooms. They were sharing a room with 2 or 3 other staff. Each staff member gets 4 to 5 days off every month. The Staff trainings are provided by HelpAge and anyone can be certified as a caregivers after 1 year program. Although I do respect staff dedication and the mission of this organization, I still could not satisfy with the environment, especially the fact that people think it is OK to have 4 elders living in the same room. When I asked them question if they are considering to make the room private, their answer was “no we cannot afford it, and also four people in the room is good enough for them.”

Since staff members as well as owners and some scholar were very happy with this environment, I asked them simple question that “Can you recommend your mother to live here?” They looked at me strange and paused, then said “we are not in the same social status. This is not appropriate for her.”

……………. Am I just a naïve idealist from Japan who just cannot understand why anyone can comment other people’s right in this way?

I, then, asked another question that “Can you share a room with three other elders, when you need care?” Their answer was that “Well, we have a different type of lifestyle from them. I definitely need my private bathroom with my own bedroom.”

………….. GOOD ENOUGH. I heard this term so many times today, and it made me depressed. Good enough is a relative concept, and means different level of life style. However, I strongly believe that we should not intentionally design the lower standard living environment than the ones in which we ourselves would be willing to reside.

Sri Lanka has so much to offer to teach rest of the world in terms of “Sharing with others,” because the concept is embedded in their everyday life. They are quite expert at helping each other in many ways. I would like to see this good quality of culture being integrated into elderly care for people in various social groups.

Should we be happy about providing “good enough care” for elders?

My answer is “Absolutely NOT!!!”

We will be talking to many elders as well as scholars who specialize aging in Sri Lanka next ten days, and I thought that it might be a terrific idea to integrate your questions into our interview process. I would like to extend my invitation to all of you to have opportunities to directly ask aging related questions to the people in Sri Lanka . I will be delighted to ask your questions (or obtain appropriate information) and post the feedbacks in this blog.

I appreciate if you could post your questions and suggestions in the comment section.  I can also be reached by my e-mail. I am looking forward to hearing from you!!

I have FINALLY arrived in Sri Lanka this morning after my long long trip.

June 25^th

9:47 p.m.Depart from Dulles Airport (7.5 hors flight)

June 26^th

10 a.m. arriving at Heathrow airport –( 5hours layover )

3:00 p.m. Depart from Heathrow  (11hours flight)

June 27^th

7:00 a.m. FINALLY arriving at Colombo airport

8:00 a.m. Picked up by Kapila

Breakfast at a locally operated historic hotel nearby the airport

and visited the following places:

• A local market
• The historic Dutch settlement and canal
• A Fish Market
• A temple in Colombo
• A shopping center (renovation project of historical house)

As soon as I walked out from the airplane, I was overwhelmed by the heat and humidity in the air. The body experience instantly made me realized that I was at the Tropical Island !! The Colombo airport was very clean and people were very friendly and helpful. When I walked pass people waiting at boarding gates, I realized the two things; 1) nobody was eating or drinking on the boarding areas, 2) nobody was working with computer. I saw most of the people enjoyed chatting with others around them, instead.

Among the many cultural experiences that I have today, the first challenge that I have learned was that “people do not necessary respect for waiting on the line.” I was naively waiting for my turn to come at the immigration area, and people walk directly to the counter in front of me… After 15 minutes of my naïve action, a nice Sri Lankan lady, probably about late 50 to early 60 years old, pushed my back softly, and said “go, go, go and talk to the guy (immigration officer)” She took me to the immigration counter, and told the officer that “please take care of her…” Her kindness made me feel so welcomed in this country immediately.

As soon as we left the airport, I started seeing so many people walking on streets. Many women wore traditional closing and most of men dress very casual, t-shirt with pants. Off course, most of them had “flip-flap” on. Surprisingly, even, the road construction workers were wearing flip flaps while  they were paving road with asphalt. (very scary….) The traffic was quite heavy, and people drive “CRAZY!!!!” on the road. It took me for while to find out that there seems to be an “order in chaos.” I was lucky that we hired a car and a driver who seemed to know all the “unwritten road rule—when to stop, when not to stop, and ect…”

Surprisingly, there were so many nice cars on the dirt roads, passing by so many poor people and their houses. It was clear that there is a large economic gap between the wealthy and poor people in this country. The thing that impressed me the most was that poor people were working so hard to live through their life. While their social economical status is low and live in small hut like houses, their eyes were shining with full of energy. I could not believe how innocent and bright their eyes were.

One more thing that surprised me by talking to my friend, Kapila, was that people are so generous in this country. Although they do not have much to share, they still manage to come up with anything that they can share with others. For example, I saw a old man in a temple who were picking up leaves on the ground, offering a help for visitors, and cleaning quietly. My friend told me that elders like him come here and hang out for all day. They come here to meditate and do anything that he could help for this temple. After talking to my friend and looked around the temple, I realized that there were many elders throughout the property listening to visitors stories and encouraging them. When I saw their peaceful face and gentle smiles, I felt that they must be truly in the journey of becoming wise elders. After visiting the temple, a little boy came to us with flower in his hands. This amazingly polite little boy was helping his family by selling a flower at the temple. He was too poor to go to school, yet, he wanted me to take the flower as a gift. This experience made me think about the value of money and human spirits.

The most important lesson that I have learned today was that money does not seem to be the key for success in raising polite/disciplined children. There seems to be critical essences that make children’s eyes shine in the society of Sri Lanka . I cannot wait to learn the value and life of people in Sri Lanka !!!

I am experiencing the information overload at this moment. There were so many more stories and my feeling that I wanted to write about, however, I probably need more time to organize my thoughts first.

P.S. I do not feel any fear by being in Colombo . It is amazing to see people live their normal lives, no matter what the political situation can bring. I will be careful not to be in any danger. 

I wanted to let my friends know that I am OK!!!

How do elders live in Sri Lanka?

What does it mean to care for elders in community?

What can we do to help elders to enjoy their life?

My colleagues and I are going to visit the country where “THERE IS NO NURSINGN HOME”, and explore the alternative living arrangement that elders can maintain their familiar lifestyle in their community. We believe that the culture and lifestyle of Sri Lankan should be embedded in the living environment where elders live in order to support their healthy aging processes. Our approach is to learn about the everyday life of Sri Lankan through in-depth interviews and observations, then apply the knowledge to create a culturally appropriate living environment where elders are able to aging in community.

Our team consists of members from Japan, USA, and Sri Lanka. This international adventure will be taken place between June 27th and July 8th. While we have carefully planed for this project with A LOT of help from local residents in Sri Lanka, we do not have much idea about “HOW IT IS GOING TO TURN OUT” at this moment. I will try to update the progress of our project as often as I can!!

Please leave your comment when you have a time to do so.

I am taking a LONG flight  to Sri Lanka tomorrow!!!