Senior citizens in China have for millennia labored throughout their lives in anticipation of specific rewards and authority during their retirement years. But today, just when exceptional material wealth is at hand, their right to preside over and be supported by a household of admiring progeny is slipping away.
Younger generations are finding it very difficult to obey the old rules. The large multi-generation dwellings of a generation ago have become an impossible extravagance for most urban residents. And the realities of modern jobs simply preclude round-the-clock care for their elders.
With mixed feelings of sorrow, guilt, and relief, many young couples now consider housing their parents in nursing homes; they still provide support, but at a greater distance. Social change is forcing an adjustment in traditional values, a process that is not altogether a happy one.
Taiwan's economic development is bringing sweeping social consequences, some of which are forcing traditional values into a new and undesirable shape. The changes are often worrisome, occasionally painful. Ironically, the elderly — those senior citizens who have been so important to the transformation of the island over the past four decades — are facing a less than happy future. Many fear that due to an altered social environment, their children will not be able to provide the protection and care they will need in the years to come.
Because public accommodations for the elderly are still limited in Taiwan, this is a valid concern. As the percentage of senior citizens in the total population grows, the problem becomes even more severe. Statistics compiled by the Department of Social Affairs, Ministry of the Interior, indicate 5.8 percent of the population is now over 65 years of age, compared to only 2.0 percent in 1946. By 1995, the figure should reach 7.3 percent. Life expectancy has steadily increased as local standards of living and medical care have improved.
Half a century ago, social roles in Taiwan were clearer and simpler, though perhaps not to the liking of every individual. Extended families lived under the same roof, and the children saw to the daily needs of senior family members. Age deserved obedience, according to tradition, and lines of authority were vertical. Moreover, children rarely strayed far from home, usually tending the fields or working at other jobs nearby.
Industrial growth in Taiwan has rudely upset that convenient arrangement by drawing farmers, or at least their children, away from the countryside and into factories, services, and professions in the cities. As segments of the family move closer to their places of employment, there is a natural fragmentation of the extended family. Housing problems exacerbate this process, for urban apartments are too small to accommodate much more than basic nuclear families. Compounding the problem, young couples have fewer children than their parents, or even remain childless. Moreover, work schedules prevent young parents from having much time to care for their children, let alone their parents.
All segments of society, from individual families to the government, have recognized the need to provide adequate housing, care, and psychological support for senior citizens. Programs designed to create a comprehensive care system for senior citizens are tackling the situation from two directions. One is directed toward those senior citizens who fall below the poverty line. It provides financial assistance for medical expenses, services by visiting nurses and social workers, improved facilities at nursing homes, and employment for those fit to work. The other focuses on those senior citizens with sound finances, but who experience psychological or intellectual dissatisfaction. In their case, the program provides self-funded nursing homes, which so far consist of two facilities: Evergreen Village and the Pine Cottage Elderly Center, both in the Taipei metropolitan area.
Other government plans call for constructing day care service centers for senior citizens; educational programs on the prevention of chronic and fatal diseases prevalent among the elderly, including instruction on cardiac ailments, diabetes, and high blood pressure; construction of leisure and recreational facilities; and special care centers reserved for the very old.
But government officials and the public recognize these programs are incomplete, since they are aimed primarily at the very rich or very poor. The vast majority of senior citizens who fall into the middle category are still left out. Nevertheless, some progress has been made, and some of the early programs, discussed below, provide rich information about how best to proceed with meeting the needs of all senior citizens in Taiwan — and also illustrate that some of the attitudes and expectations of elderly people are changing as well.
Evergreen Village and the Pine Cottage Elderly Center demonstrate that the government can successfully assist in providing substantial programs for the elderly. Evergreen Village was established by the Free China Relief Association in December 1984, and the Pine Cottage Elderly Center was established by the Department of Social Affairs of the Taipei City Government the following year. Both facilities charge a fee to residents, most of whom are supported by their children, and both provide first-rate medical clinics, recreational centers, and a safe and comfortable daily environment.
Wang Yu Chieh-hung, the mother of Chinese-American astronaut Taylor Wang, lives at Evergreen Village. She learned of the facility three years ago during a return visit to Taiwan with her son, who took her to see an old friend living there. The serenity and beauty of the site impressed the senior Wang so much that she decided to move in.
"At first I worried that my youngest daughter might not be able to live independently," she says. "I'm an old-fashioned Chinese mother, so I wanted to take care of her until she found a husband. But children are resilient these days, and they must grow up fast. Besides, I thought it was about time I devoted some time to myself. I spent all my life serving my husband and children, so didn't I deserve some fun for a change?"
Today she spends her days chatting with old friends, strolling around the grounds, and keeping physically fit. Wang is happy, as are most of her companions, for the Village offers a tranquil, carefree life in which the elderly can hold on to their own opinions and habits without arguments or challenges from the younger generation.
The social atmosphere at Pine Cottage Elderly Center is equally comfortable, and has produced some surprising results. In February 1985, for example, the Center witnessed a marriage between 84-year old Liu Lin-fang and his sprite, 78-year old girlfriend Weng Li-yao. Weng already had great-grandchildren, but she saw no reason to forego the pleasures of becoming a blushing new bride once again. The reserved but energetic groom speaks with great contentment about his life as a newlywed: "We share our lives and our interests together. One of her preoccupations is playing the stock market — that seems to be a big fad these days!"
Pine Cottage is so popular that many senior citizens have waited eagerly to be admitted. One such resident is former Tainan City Councilor Kuo Tseng-ho, now a vigorous 77 years old. He entered the Center in 1985, when it first opened to the general public. Kuo enjoys a private room and a living environment completely suited to his needs. Except for one blind eye, he is sound of body and likes to spend hours each day talking about old times with friends. He also indulges in an occasional game of mahjong.
Kuo is blessed with three well-to-do sons and a married daughter. Independent in his own life, he insists he does not want his children wasting their time worrying about his welfare. "My children don't run my life, and I don't run theirs," he says. "They have families and careers, and I see no reason why I should add to their burden. We visit each other when we feel like it, and I like that a whole lot better than forced proximity."
But Kuo's attitude is unusual. Many other senior citizens have no idea what it would be like to live independently from their children. To leave the home in which they have long enjoyed comfort is not seen as a positive alternative. They are caught in a dilemma, since the households of today are already too cramped for comfort. Future government programs for senior citizens may have to include counseling to help them adjust psychologically to modern realities.
Kuo's third son, a 38-year old sales executive, says their family is fortunate that things have worked out to everyone's advantage. "My father found out about Pine Cottage while he was a city councilor," he says. "My brothers and I knew nothing except that the sons were supposed to take care of the parents. The government today does far too little for the elderly. I think my father was lucky; other senior citizens aren't."
The younger Kuo points out that problems in dealing with elderly family members are experienced throughout Taiwan. "The generations try to tolerate each other's values and habits, but the pressure of work, family, and modern life often mounts to the breaking point for couples tending their aged parents," he says. "My generation confronts some real challenges. Welfare didn't exist as a social institution or in people's minds a generation ago, and even today many cling to impractical ideas of filial piety that do more harm than good. Social opinion and pressure to save face aggravate the problem. I have lived through the period of transition in Taiwan, and I think the idea of filial piety could use a serious overhaul."
Kuo adds that the moral requirement of absolute obedience to parents needs to be replaced by a more liberal concept permitting offspring to meet the needs of their parents within the limits of reason. "That means letting the parents live in their own time and space, while still showing concern and affection for them," he says. "But it need not be done at home simply to appear 'filial' in the eyes of society. The world is changing fast, and we must adjust. I often wonder what kind of old age I will experience, or my children."
Unfortunately, the government nursing home system does not yet extend to the majority of senior citizens who need assistance, whatever their financial status. And what is available receives inadequate publicity. But many people feel much greater emphasis must be given to senior citizens. The younger Kuo puts it bluntly: "The government has no reason to delay, since it can now well-afford to pay much greater attention to social welfare. "
In contrast to the manicured gardens and gleaming-white clinics of Evergreen Village and Pine Cottage, there stands a somber cluster of worn, smog-stained buildings just off a busy road in Taipei's Sungshan District. It is one of the numerous facilities the government provides to offer shelter for orphans, abused young girls, and the aged. This particular facility is known as the Taipei Kuang Chi Relief House. It houses and medically treats the aged, as well as offering recreational programs and a place for religious worship to the poor in Taiwan. The larger portion of the site has living accommodations for senior citizens, usually one room per four occupants. The medical services are well-organized, though other aspects of life at Kuang Chi are far from luxurious.
Army veteran Wang Tzu-mu is 73 years old, and has lived at Kuang Chi since 1983. He came to Taiwan in 1950, some time after discharge from his army regiment in Shanghai. It may seem strange that Wang does not live in a nursing home for veterans, but his situation was peculiar, though by no means unusual.
"I had no document of discharge from the military, since they were unavailable to those dismissed from service while still in mainland China," he says. "Without such a document, I don't qualify to live in a nursing home for veterans. Residents at those homes enjoy free food, clothing, and medical treatment, as well as an allowance of US$180 per month. Here at Kuang Chi, we have an allowance of US$32, which doesn't leave enough to buy cigarettes or wine, and certainly not gifts for friends. On top of that, we must buy our own medicine when it's not available at the clinic. And if we need to recover after surgery, we must pay someone to look after us."
Wang derived little reward from the ROC's economic boom. He tried his hand at business after coming to Taiwan, but ended in bankruptcy. Penniless and without friends or relatives capable of helping him, he acted upon the advice of his companions and moved into Kuang Chi Relief House. Currently, he acts as the head of a group organized by the residents to assist one another. He also heads groups of senior citizens at other relief facilities similar to Kuang Chi.
"I don't have much free time, but when I do I like to stroll around outside," he says. "The other residents also work during the day, if health permits, and many more help care for the disabled or tend the garden. For recreation, we play chess, drink tea, and chat."
Kuang Chi is an example of one of the government's earliest attempts to provide assistance to the elderly. Such facilities were targeted only for the very needy, responding in part to the traditional structure of Chinese society where most families cared for their relatives at home. While disadvantaged people can receive services at Kuang Chi or similar homes for the aged or disabled, those who are in any way capable of self-sufficiency must stand on their own. Until recent years, only the extremely poor senior citizens could qualify for free clothing and medical services, food subsidies, and a small financial allowance from the government.
Hampered by financial and manpower constraints in the past, the government was able to do little else to help the destitute. Yang Ching-ching, a specialist at the Department of Social Affairs (DSA) of the Ministry of the Interior, says that improvement is on its way. "The DSA will be granted much better funding starting in 1989," Yang says. "We expect to upgrade the quality and quantity of our services, and the government is laying the groundwork for that now."
Tsai Han-hsien, who is director of the DSA, is convinced that the lives of senior citizens will improve with greater cooperation between the government and individual families, local organizations, and private bodies. He adds that the government is implementing clearer and better policies on welfare for the elderly, and is stepping up efforts to distribute books, pamphlets, and videos to educate the public on the subject.
But much remains to be done because of changing traditions of family support and attitudes toward "face" and filial piety in contemporary Taiwan. The question of how best to give the island's senior citizens the rich life they deserve during their retirement years requires both substantial changes in the social services infrastructure and hard rethinking of ethical traditions.