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Aging in
Cuba:
Realities and challenges
By Alberta Durán Gondar and Ernesto Chávez Negrín
TEMAS,
April-June 1998
Demographic
aging is a complex issue of growing interest, complexity and
importance worldwide.
As far as we know, this
phenomenon does not affect plant and animal populations--or at least
does not occur spontaneously, but only in the event that human
beings intentionally interrupt their life cycles. Even
in human populations, aging is a recent phenomenon, dating from the
mid-19th Century when it became possible to control
reproduction. (United
Nations, 1978.)
Moreover, well-researched socio-demographic studies project that
the 21st Century will be the century of aging for the
world's population.
Paradoxically, despite the momentous and highly topical nature of
this question, there appears to be confusion about the concept of
population aging among non-specialists, government
organizations and, oftentimes, even among those with a certain level
of demographic knowledge.
The first difficulty lies in the definition of population aging
itself. Often it is interpreted to refer to an increase in the
number of elderly people-people over 60. However, the key
element in the definition of population aging is an increase in the
proportion of elderly people in the total population, and especially
in relation to children and young people under 15. That is,
population aging is not just a matter of more older people, but
rather is defined by an increase in this segment of the population
relative to the population as a whole. (Valentei, D., 1978).
If the degree of population aging could be determined by the
number of people over 60, then China and India would be the most
aged populations in the world, since theirs are the largest
populations and the largest populations of elderly people in
absolute terms. However, since population aging is determined
by the percentage of people above 60 in a given population, Sweden,
Norway and other nations in northern and eastern Europe are the most
aged nations in the world.
A second-and more serious-confusion originates from the mistaken
notion that a given population ages due mainly to a decrease in the
mortality rate and an increase in life expectancy at birth.
The renowned US demographer Ansley Coale, in a concise and brilliant
article in 1955, demonstrated irrefutably that decreases in
mortality have not produced an older population, and that the key
factor explaining the notable aging of Western populations is a
decrease in fertility rates (Coale, A., n.d.; page 7).
In fact, when a country or region experiences a decrease in
mortality, children under five are the main beneficiaries, and to a
much lesser degree, the elderly. The reason is that the main
achievements in the fight against death thus far have been those
related to infectious and parasitic diseases as well as ones of
exogenous origin; advances have been more discreet against diseases
which are endogenous, chronic, or non-communicable, all these more
commonly associated with the elderly.
Therefore, for example, while life expectancy at birth extends
from 60 to 75 years-as it has in Cuba over the last four
decades-this alone does not imply aging of the population.
Just the opposite, in fact: it results in population
rejuvenation, since although there is an increase in the number of
older people, there is a more significant growth in the number of
children and young people.
In fact, if the Cuban population has aged over the last four
decades, this has occurred despite the reduction of
mortality, and is due instead to lower fertility (birth rates).
Another example: in the last few years Cuban medical teams have
offered medical attention free of charge in remote rural areas of
many Central American countries and Haiti, all areas with high
mortality rates and very low life expectancy at birth. It is
clear that mortality rates-especially infant mortality-will decrease
in there in the near future. If this is the case, then life
expectancy at birth will surely increase by several years. But his
will not bring with it an aging of these populations-rather, a
decrease in the average age of the population, since many children
who once perished will now survive.
However, if such reductions in infant mortality should
consolidate as a tendency, then decreases in the birth rates should
also be observed over the medium-term, as couples will not need to
have as many children to assure that at least some survive to
maturity, and this would bring with it a tendency towards aging of
the population.
A final example: when, according to the Bible, Herod gave orders
to kill all the boys in Bethlehem and its vicinity under two years
old, this resulted on the one hand in a sudden increase in infant
mortality and, at the same time, a decrease in life expectancy from
birth in the Kingdom of Judea. Moreover, there was an increase
in population aging, since older people suddenly occupied a greater
share of the total population. Thus, it is clear that a
relatively high mortality rate in the early stages of life
contributes to population aging. A similar effect is seen as a
result of a decrease in fecundity rates.
The Aging of the
Cuban Population
In the 20th Century, Cuba's population has become
increasingly older, due to a change in the population's reproductive
patterns, a process known as "demographic transition".
During the first half of the 20th Century, this increase
in the proportion of older people was small (from 4.6% in 1899 to
6.9% in 1953), and remained so from 1953 to 1970 (9.1% in
1970), and until 1990 (A. Durán and E. Chávez, 1997).
However, from 1990, the aging of the population has intensified, so
that by 1998, older people constituted 13.6% of the Cuban
population (Cuban National Statistics Office, 1999 "a").
Numerically speaking, in 1899 there were only 72,000 older people in
Cuba, while in 1998 the number had grown to over 1,518,000 (Cuban
National Statistics Office, 1999 "b").
Currently, urban areas have more elderly (14.1%); and women
represent the greater share of older people in Cuba, 14.1% of whom
are already 60 years old.. Elderly
people represent over 15% of the population of Villa Clara, City of
Havana and Sancti Spiritus Provinces. The population of the
Isle of Youth Municipality-deserving of its name-has less than 8%
elderly among its population. In the rest of Cuba's provinces,
the numbers fall between these two extremes: 10.5% in Guantánamo
Province to 14.6% in Havana Province.
In the long run, the fact that the fertility rate has remained
low since the late 1970s-and especially in the 1990s-allows us to
predict an acute increase in the aging of the Cuban population in
the future. Consequently, in the year 2015 the proportion of
elderly people in Cuba is expected to be as high as one of every
five people; one of every four in 2025; and one of every three by
2035-a proportion not yet attained in any other country of the
world. This proportion is expected to remain almost invariable
until the year 2050, when, according to current projections, the
Cuban population will include over a million octogenarians,
representing almost 10% of the country's population (CELADE,
1997).
We do not regard such an advanced demographic aging process as
catastrophic. But neither do we do we side with those who
disregard it, or with those who consider it a positive event because
it reflects a population dynamic similar to that of economically
developed countries.
In this sense, we consider two observations appropriate: first,
it is important to remember that many rich countries experience
several negative phenomena such as high rates of contaminating
emissions, traffic accidents, violent crimes, etc. Thus, it is
unacceptable to adopt developed countries' patterns as paradigms
without distinguishing between the beneficial and prejudicial.
It is clearly positive to see that Cuba has achieved levels of
infant mortality similar to those of Western Europe; yet, we cannot
make the same positive comparative assessment for Cuba's low
fertility rate. To congratulate ourselves for such an
achievement would be similar to taking pride in an increase in
environmental pollution or traffic accidents, because such increases
would bring us closer to the patterns of rich nations.
Second, there is growing concern, even in the European countries,
about the future consequences of the aging of their populations.
For instance, according to a recent report from the Center for
Economic Investigations and Business in London, as a result of the
aging of Europe's population, the labor force could begin to decline
by the year 2005, and consequently economic growth will be hampered
and state pension and health care programs in near bankruptcy. The
same press report cites the Center for Economic Research and
Business' warning that, as a result, the European Union could
experience a major economic crisis whose aftermath could destabilize
governments and cause distortions in the Euro (CNN, 1999).
Turning to Cuba, let us examine the possible consequences of the
tendency towards population aging that we have described.
In the economic field, the consequences include an accelerated
demand for the funds to cover social security expenditures. In
fact, since 1970 funds budgeted for old-age, disability and death
benefits have quintupled. National budget expenditures for
social security are higher than those of any other sector (e.g.
education, health, defense, etc.) (Cuban National Statistics Office,
1999 "c").
At the same time, as the average age of Cuba's workforce
increases over the coming years, we will see a deficit of workers
for labor requiring greater physical effort, especially for
agriculture, construction and industry, among others.
Consequently, the main economic difficulty Cuba faces today-as it
did during the colonial period and at the beginning of the 20th
century-is an insufficient workforce.
Another important consequence of population aging is an increase
in the demand for goods and services required by older people,
especially medical services and medications. Although old age
is a natural stage of life and not a pathology in itself, it is also
quite true that especially after 75, people experience greater
sensorial losses and more frequent chronic disorders of both mind
and body, all of which may require prolonged medical treatment (Durán,
A. and Chávez, E., 1998).
Within the family, population aging is associated with a
reduction in the average household size due to low fertility rates
and an increasing number of households with only one or two older
people who live alone.
In accordance with Cuban family tradition, whenever feasible
elder members of the family live in their own homes and with their
own family for as long as possible. However, because a growing
number of older people either never had children or live far from
their offspring, more elderly people live in old-age homes (12,333
in 1997) (Cuban Ministry of Public Health, N.D.). At least
another 5,000 are waiting to be admitted (Latin American Center for
the Elderly, 1996).
Because mortality rates are higher in men, women often live a
good share of their later lives-sometimes over a decade-as widows.
Moreover, women are the ones who most often care for elderly family
members, which overburdens their household chores, especially when
these are not adequately shared by other members of the family (Chávez,
E., 1998).
Characteristics
of Population Aging in Cuba
Although the process of population aging in Cuba is similar to
that of other countries, there are, some distinctive features
(Durán, A. and Chávez, E., 1997). These can be summarized in
three main points:
1. Demographic aging in industrialized countries has coincided
with-or at least lagged very little
behind--economic development. Thus, these
countries have been able to deal with this
process in conditions quite different from those
Cuba faces today. Among the differences:
- Technological
Development:
In economically developed countries, goods and services are
produced with high-tech methods requiring less labor; while in
Cuba, economic efficiency is still low and many activities
require physical effort and abundant labor force.
- Quality
of Life:
The elderly in Cuba have not enjoyed the same levels of
nutrition, availability of medications, housing conditions, home
support services, transportation services, recreational
opportunities, and general standard of living throughout their
lives as, for example, the elderly of Sweden or Holland.
And much less so, since the economic crisis of the nineties.
Thus, their later years of life will also be quite different.
- Migratory
Pattern:
While rich countries because of their wealth attract young
immigrants, this is not the case for Cuba, and it is difficult
to imagine a significant influx of population in the future. In
fact, Cuba has experienced a systematic negative balance of
migration since the 1960s. Between 1994 and 1998 alone,
150,000 people emigrated from Cuba (Cuban National Statistics
Office, 1999 "a").
2. The velocity and intensity of Cuba's demographic aging process
is far greater than that
experienced by the European countries. While
countries like France, Sweden or Germany
took several decades or over a century to
complete their demographic transition, the
decrease in the fertility rate in Cuba has taken
place much more swiftly: from a rate of 35
births per 1,000 inhabitants in 1964 to 15.4 in
1978. (Cuban National Statistics Office,
1999 "a"). Since 1978, the
fecundity rate does not guarantee population replacement in the
long run. This tendency has become more acute in
the nineties. If current demographic
patterns remain unchanged over the next few
years--especially the low fertility rate--the
Cuban population is very likely to experience an
absolute and systematic decrease as early
as the year 2015.
3. The process of population aging in Cuba is not occurring in
optimal international conditions,
but in harsh times of an economic crisis
resulting from the collapse of the European socialist
bloc and the disintegration of the Soviet
Union-nations with which Cuba carried out 85% of
its trade. This situation has been
compounded by the tightening of the U.S. economic,
commercial and financial blockade against Cuba,
first through the Torricelli Act, and later
through the Helms-Burton Act. If the acute
aging of the Cuban population over the next
period were not accompanied by significant
economic and technological development, the
population's standard of living would decline as
well as the country's defense capabilities.
This could become an incentive for the more
conservative sectors of U.S. politicians in their
attempt to reestablish U.S. influence over Cuba.
Some
Alternatives for Future Action
In Cuba, as in all civilized societies, we must work towards
increased longevity for our population, for an acceptable quality of
life for the elderly, and for a more fully able and capable old age.
This does not negate the fact that the intense process of
population aging in Cuba constitutes a real and serious problem with
various and complex consequences for the whole society. Faced with
the challenge of even more rapid aging in the next century, and a
population that will not regenerate itself at current levels, we
might consider three alternatives for action:
- Leave things as they are, with the hope that
sometime in the future, the fertility rate will recover on its
own, as a result of an eventual improvement in the country's
economic situation or other occurrence.
- Wait to act until the consequences of population
aging are more tangible, such as notable deficits in the labor
force or difficulty in paying the ever-increasing social
security costs.
- Act now to encourage demographic equilibrium.
It is clear that only the third option offers a real
alternative--if applied within the principles of absolute respect
for individual reproductive rights-since demographic trends have
considerable inertia and are, therefore, hard to modify over the
short tun, above all when reproductive behavior has become
tradition.
Moreover, while the Cuban experience indicates that fertility
rates can drop without a specific policy designed to achieve this
goal, it does not seem likely that the opposite will occur
spontaneously: that is, that the fertility rate will recover.
Increasing fertility rates has been very difficult for developed
countries, even once they have applied deliberate and expensive
policies with this objective.
We believe that, in Cuba, recovery of the fertility rate should
be attempted, among others, through measures aimed at
reinforcing the family as an institution and a social group.
Such measures should offer greater support to families in the
fulfillment of their functions, thus contributing to their
stability, especially in the case of young families. They
should also use public education and the mass media to promote the
optimum of a two-child family.
Perhaps the advent of the 21st Century will bring new
forms of human reproduction such as cloning, or perhaps other as yet
unimaginable techniques, which will change our current concepts and
predictions. However, as long as this is not the case, we
believe the best alternative is to promote "traditional"
reproduction methods that guarantee generational continuity for the
future of Cuba's population.
Individual Aging
Socio-psychological research on older people has advanced further
than the study of population aging. However, the results
obtained do not yet offer enough to fully understand the individual
and social needs of old age. One of the starting points for
this would be, for example, to change attitudes such as the use of
pejorative terms to refer to old people like rusty, shriveled with
age, old crock, oldster, etc. as well as doddering, wreck,
decrepit, worn out, senile, and so on.
We have successfully introduced new "milder" terms such
as "third age", "the elderly", "senior
citizens" to refer to older people, terms preferred by some
more than others. But we have not been able to eliminate the
general negative and pessimistic sense that the general population
and even some specialists associate with old age, as the last stage
in life.
Moreover, although advances have been made in biological studies
on aging, still little is known about the sociological,
psychological and anthropological characteristics of this age group.
And less even about older age as a stage in personality development,
since evolutionary psychology generally treats this subject through
adulthood, at best.
Western societies put a premium on youth. Maintaining a youthful
appearance and dynamic spirit are considered key to personal
success. The aging process among older individuals requires
them to face a series of inevitable "losses": those who
once worked now retire-for some, a time to rest from long and tiring
activities; but for many, a rupture with their personal history.
Most older people experience reduced social contacts, loss of
relatives and friends, economic losses, and diminished social status
and self-esteem. All this generates stress and requires
numerous personal and social resources to successfully adjust to
these changes.
A reduction of physical capabilities, which may be related to
health problems, is an inevitable consequence of aging. For
most elderly people, these changes mean they tire more easily when
carrying out daily activities, and they experience a decrease in
sensory and motor capacities. Such physiological changes have
a psychological impact on older people and influence their feelings
of wellbeing. Argentinean poet Baldomero Fernández Moreno
described it this way: "old age is a tiredness that does
not disappear the next morning, as we ingenuously expected upon
going to bed".
The individual's response to these losses depends on their
personality. Some accept these realities in a
passive-dependent way; others try to replace the lost roles with new
ones-grandparent, neighbor, member of and organizations, etc., thus
becoming involved in new social activities that both interest them
and help them enjoy their free time. Most specialists
emphasize the importance of activity, not only physical activity,
which some have defined as "the road to eternal youth",
but also social activity and active involvement in family and
community life. This undoubtedly helps the aging to find
renewed personal meaning for their lives and to create new
expectations of their last years of life.
The individual's response to old age-adjustment, depression, or
confronting and overcoming new problems-depends not only on personal
characteristics, but also on the opportunities offered by society at
all levels: family, community, region, country.
Various "pressures" can influence the degree of older
people's social participation, such as pressures emerging from
changes in their relationship to their environment, including
changes in social roles in the family, at work, regarding economic
status or power relationships. Other pressures may relate to
symptoms of physical deterioration-aches and pains, loss of energy,
memory lapses, etc.--and the "awareness... that the future is
limited and death is not only inevitable but is not very far
away." (Kalish, R.A. 1996; p. 122).
Social networks can provide emotional support for older people,
as well as information to help them solve their problems-this is the
so-called strategic support. These networks provide practical
assistance in those cases where the person is unable on their own to
accomplish a task. However, the social interactions in these
networks are not only of an altruistic nature: they can also
generate conflicts and lend themselves to other motivations.
Thus, it is particularly important that each person is analyzed
according to their own situation and personality, and rigid and
generalized solutions avoided.
All of the researchers and theoreticians consulted agree that the
family is the main social group in which older people can be
encouraged to carry out different roles. The family as a
social network can become the first step toward their social
integration and participation. It can become "the first
resource and the last refuge" for these people. However,
the family can also generate conflicts or threatening relationships
for older people.
In every country, cultural traditions and the level of
socioeconomic and political development establish differences in
family and government responsibility for attention to older people.
In some countries, specialized services for the elderly are
expanding, and in this case the family either feels relieved or
replaced, as its responsibilities are taken over. In other
countries, where most older people live on their own, the family is
described as a "modified extended family" where several
nuclear families living apart are nevertheless united by bonds of
affection and maintain frequent social relations in a form that has
been termed "distance intimacy" (Bazo, M.T. 1990).
In the Latin American pattern of family relations, each family looks
after their elders when they need help and only fail to do so in
very special situations (Sánchez, C.D. 1990).
In Cuba, approximately 90% of older people live with other family
members, mainly with their descendants. This situation, which
differs substantially from other countries, results not only from
historic cultural patterns, but also from housing limitations.
There is insufficient housing to allow young people to live on their
own when they start a family. Rather, they are obliged to live
in the nucleus where they were raised, or in the home of a friend or
other relative. Therefore, whatever the cultural
pattern, most Cuban elderly people do not have the opportunity to
live alone, even if they wanted to, and over one third of Cuban
families have at least one member who is over 60. This means
that Cuban families are called upon to play a crucial role in the
attention of older people and that further analysis is needed of
this reality. The Cuban family is not simply one of the
players in the elderly's social support system: it is the
fundamental source of support for most elderly.
At the same time, in spite of Cuba's economic crisis, social
security services have been maintained, and pensions paid, unlike
the situation in many other Latin American countries when faced with
crisis. This, plus social assistance support offered to older
people, provide for a certain degree of personal economic
independence and satisfaction of basic daily needs.
Older people in Cuba have access to free medical care at primary,
secondary and tertiary levels, including general and specialized
services. This creates an important sense of security for
these people and their families, who are well aware of the growing
needs for medical assistance in old age. Current efforts to
increase the number of geriatric services and to provide specialized
education for family doctors-who are the mainstay of primary health
care-will undoubtedly improve the quality of these services in the
near future.
One important achievement has been that the general public
recognizes and supports the level of attention and specialized care
required by the elderly. Communities carry out projects aimed at
ensuring a better quality of life for their elderly members.
Moreover, "community solidarity" has made an important
contribution in terms of spontaneous help offered among neighbors.
However, we believe the precise role of the family in these
community and social projects is not sufficiently concretized. This
constitutes a clear weakness if we consider that most elderly live
with their families.
Outcomes of
Sociopsychological Research on Aging
Since 1996, our workgroup has carried out several studies on the
relationship between aging and the family group. We do not yet
have all the necessary outcomes to characterize this complex
relationship. However, our initial study of 60 older people
conducted between 1996 and 1997 in six municipalities in the City of
Havana, based on a qualitative approach, resulted in a number of
interesting sociopsychological features. (See: Durán A. and Chávez
E., 1997).
On the one hand, many of these elderly people did not consider
the help they receive from the government as sufficient. Some
of them stated that their pensions were only enough to cover their
most minimal needs, while others found their pensions completely
insufficient. Only a small group was satisfied with their
pensions. However, most of the subjects included in the study
said that the elderly suffer economic hardships due to the due to
the current high cost of living.
Many of those interviewed described their medical care as
adequate. But they also described it in curative terms rather than
preventive. Shortages of medical supplies-mainly medicines,
eyeglasses, and hearing aids-plus difficulties in maintaining
adequate nutrition and solvency led many to express insatisfaction.
At the same time, it is clear that more work needs to be done to
increase opportunities for older people to socialize and relate to
new social contexts: in particular, those that would help
develop new personal capabilities and incentives, as well as use
their accumulated experience, knowledge and interests. In our study,
few of the elderly had joined or maintained their membership in
Senior Citizens' Clubs; none was a member of the retirees' clubs
created by some trade unions. Yet, these are the two major
social organizations for older people aimed at developing their
interests and social relations.
Leisure time activities, another important aspect of older
people's social participation, are limited to the home, with few
options. The most common ones include watching television (in
most cases) or listening to the radio (less frequent). The
vast majority of our subjects stated that their main leisure
activity was "resting without doing anything" on a daily
basis and for longer than they would like. Those few involved
in activities outside their homes participated in religious
services, visited friends and relatives, and joined activities
organized by community groups. In very few cases people
referred to attending sports or cultural events, going on excursions
or eating out. Moreover, many of them stated that they carried
out most of their free-time activities alone. Only rarely did they
have company, although many of them cannot-or do not wish to-carry
out these activities by themselves. Some of these people
revealed that they felt lonely by virtue of a lack of communication,
even when accompanied by their relatives.
In fact, the most generalized difficulty among these people was
the lack of adequate interpersonal communication with relatives
regarding their needs. This reaffirms the existence of a
problem that our workgroup has already described: most Cuban
families are not prepared for complex relationships among their
members. They have established positive relations of
cooperation and support, but also relations of power, conflict and
intimidation, either in relation to the older members or provoked by
them against the rest of the family. Thus, our study shows
that the family is the main support for older people, both because
of the constant contact it offers as well as the positive
significance of interchanges with children, grandchildren, brothers
and sisters. Yet, in many cases conflicts arise between these
elders and the relatives living with them, sometimes viewed as
generational conflicts. There may also be important
interlocutors missing with whom older people would communicate.
And finally, we observe a certain tendency to idealize relationships
with members of the family that do not live with them.
The world lacks sufficient scientific knowledge about the
elderly-either as a social group or as a stage of psychological
development. There is a generalized lack of experience among
social organizations and institutions, and above all within the
family, to confront problems of individual aging and their
consequences. Thus, up to now it has not been possible to
formulate strategies that prioritize attention to the psycho-social
needs of these people, which involve various social actors,
including the elderly themselves, without hyperbolizing the role of
medical care.
Many social beliefs regarding old age reveal prejudices against
this age group. According to these beliefs, older people play
a passive-dependent role in society and become objects of social
attention rather that active subjects in their own development.
What's more, only in rare cases in the media are older people
portrayed as capable individuals who contribute to society, images
that could change negative social concepts and offer positive models
both for older people and for other generations.
In our study, some interviewees complained of scarce
representation of older people in social and community organizations
and institutions, and of the lack of formal groups focused on their
interests and that help them put their potential to use.
According to the outcomes obtained thus far in our study, we also
consider the following as characteristic features of older people in
our country:
- Among the most common sensory problems in older
people, only three out of 10 complain about difficulty in
hearing and six out of 10 suffer from failing vision, the latter
often solved by surgery or adequate eyeglasses.
- In spite of their ailments, most older people are
capable of looking after their personal hygiene and care, and
even of taking charge of daily household responsibilities for
the rest of the family with whom they live. Among these
tasks, one out of six older people looks after his/her
grandchildren, children and/or other disabled older people; one
out of 10 looks after the family's pets. The older a
person becomes, the harder it is for them to clean the house,
take their medications on time, wash, iron or cook-in the latter
case, complicated by the fact that many homes cook with
kerosene.
- Older people in general experience difficulties
carrying out activities outside their homes, and these problems
increase with age. Certain losses in ability affect
walking and climbing stairs without assistance; and more complex
activities such as visiting the doctor, running errands, or
using public transport become more difficult as time goes by.
- Very few old people return to gainful occupation
after they retire or become employed for the first time;
however, there is an increasing number of older people who wish
to do so, mainly for the earnings this would represent.
- None of the older people we interviewed is
studying something new, although some of the religious believers
study the Bible rather regularly in search of guides for
understanding and dealing with their reality. Almost four
out of ten older people never read, not even newspapers or
magazines. On the other hand, the same number do read
newspapers and magazines.
- Those who have a spouse do not emphasize their
role. And while none of them considered their spouse to be a
negative source of conflict, they made little reference to
satisfaction or support from their partner.
- Only one third of the older people in the study
maintain relationships with old friends, mainly their
contemporaries. Another one third say they have no
friends. Most of them relate to their neighbors, from whom
they perceive a source of support but also of conflict.
- Older people seem to relate more with other
elderly people and find more satisfaction in these relationships
due to the similarities in their experiences and opinions;
however, there are older people-although fewer in number-who
maintain a level of relationship with their children's and even
grandchildren's generations, although this kind of relationship
may tend to generate further barriers in the interpersonal
relationships between these generations.
The limited number of opportunities that society and the family
offer for older people to participate in "productive"
activities, and thus to relate to their social environment, should
help to explain the individual subjectivity of the older people in
our study. The psychological peculiarities expressed in the
way they represent their reality, their moods, the images they use
to characterize their individuality, their expectations of the
future and their real capabilities should at the same time temper
the relations of each of these individual personalities with their
environment.
Among the older people we studied, we found the following
characteristic subjective features:
- They do not feel useless, more unlucky than
others, afraid of their reality, although they do feel bored,
worried and very often they feel sad and on the verge of crying.
Half of these people consider their lives empty. Over a
third expressed states of mind typical of depression.
- Only one fourth have positive images of
themselves; poor self-esteem prevails among them and they
underrate themselves due to their current personal losses of
capabilities,health, happiness, physical beauty, activity and
power.
- As to future expectations, only two out of 12
older people showed real aspirations for their future-that is,
incentives to act. Most of them prioritize solving their
health and wellbeing needs, followed by other needs such as:
personal relations, material needs, new opportunities for social
participation. Due to the fact that these wishes lack
objectivity, they do not serve as real incentives for action.
- Six out of ten of these older people expressed
wishes that had some relation, showing a certain degree of
stability in the individual needs revealed by these wishes.
Moreover, seven out of ten of these individuals who say they
have material or relational needs give priority to them in their
lives, revealing the urgency with which they are felt.
- Only one out of ten reflected the need for or
motivation to further social activity, specifically returning to
work or participating in recreational activities.
- Consensus prevailed in observing that older people
are useful and can carry out many activities, that they act as
good mediators in the conflicts between their children and
grandchildren, and that they enjoy talking with children.
- Half of the interviewees accept as true the belief
that old people tend to be rigid and prefer isolation.
Yet, none of them considered themselves inflexible or loners.
Rather, they assign these characteristics to others, which
can be interpreted as a projective defense mechanism.
- Most of these subjects expressed negative opinions
of young people. Almost eight out of ten considered young
people disrespectful of older people and accused them of
disregarding their needs. Six out of ten say they don't
get any help from young people.
- The images evoked when evaluating their
families-including both positive and negative aspects-were more
commonly related to the climate of interpersonal relations among
family members and fundamentally affectionate interchange.
When speaking of what they liked about their families, they said
it was important for them to feel affection.
Without trying to impose our views on achieving an acceptable
quality of life for older people, we must conclude that when most
older people have poor opinions about themselves, poor self-esteem,
lack of aspirations and numerous symptoms of depression, they must
lack a sense of personal wellbeing. Perhaps French thinker
Blas Pascal was right when he said three centuries ago: "There
is nothing so unbearable for man as complete rest, with no passion,
occupation, distraction or care. It is then that he perceives
his insignificance, his isolation, his insufficiency, his
hollowness."
Challenges of
Population and Individual Aging in Cuba
for the 21st Century
In the context of a comprehensive, stable and sustainable
strategy of development, it is absolutely necessary to promote
as soon as possible the establishment of a demographic policy aimed
at achieving a balance between fertility rate and the rate of
migration to other countries. The possibility of changing
current patterns will decrease over time, and leaving them unchanged
will pose a serious risk for Cuba both in the medium and long term.
This demographic policy should be based on absolute respect
for the rights of families and individuals to decide their own
future. It also must take into consideration the need to
maintain population and individual aging rates under constant
surveillance through multidisciplinary research in the field, in
order to predict possible consequences.
Attention to older people as a quantitatively important and
qualitatively distinctive social group today-and moreso in coming
years-requires the creation of a national coordinating body with
certain powers under law to centralizes the work of the agencies
charged with this responsibility. Moreover, this also implies
the need to create an institutional mechanism for older people to
express their opinions and defend their personal interests as a
population group with special needs and features.
Taking into consideration that many older people have scant
economic resources in the face of higher costs of living in Cuba
today, and that there is both a need and a wish to open new avenues
for their productive activity--as a contribution both to society and
to their personal fulfillment and self-esteem-it is important to
think about establishing more flexible job regulations for retirees.
This might include working half a day every day, or only twice or
three times a week, flextime, self-employment, and other measures.
In order to improve so-called "formal support" to the
elderly, more specialists in geriatrics and gerontology are needed,
and Family Doctors should receive more preparation to guarantee
preventive, customized and systematic attention to the elderly.
The existing Senior Citizens' Clubs should be revitalized by
increasing the social and recreational options offered for the
elderly.
It is important to involve the Committees for the Defense of the
Revolution and the Federation of Cuban Women at the community level.
These organizations can become direct channels for the solution of
older people's needs and for their incorporation into social
activities. Furthermore, it is also important to have the
support of the neighborhood People's Councils for initiatives
directed especially at improving the quality of life for older
persons.
A very important aspect of the work in the community is the
development of educational and recreational programs, sports and
cultural events, in which older people can contribute their personal
and professional experience to activities aimed at improving
production and social services in the community, contributing to the
education of new generations and solving their own problems.
For older people to become active and transforming members of the
community, they and those approaching retirement need new
opportunities for learning and developing new potential. For
them to become subjects-rather than the objects-of their own process
of socialization is one of our society's main challenges.
Finally, we think it is important to address family education
where older people live with other generations, in an effort to
involve the elderly in the family's plans and seek new resources for
better intergenerational communication and living.
Considering the family as a mainstay in social policies for
"informal" attention to the elderly, and as the main
protagonist in the socialization of older people goes beyond
designating the family as "caregivers" of the elderly.
The dynamics of family relations can have a more positive or
negative impact on older people's individual development, but
reducing the family to mere helpers of the aging generalizes the
image of older people as incapable, a description that the majority
of them neither want nor deserve. Arriving at an older age is a
privilege that our society offers to today's younger generations;
therefore, our elders deserve to fully and creatively enjoy the life
that many generations of Cubans have built for them.
Consequently, there is a growing need for scientific and social
resources to help us understand, accept and transform old age into
period of continued social contribution corresponding with the
humanistic ideals of Cuban society.
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kkk
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*This
is an original article for MR by two specialists at the Center for
Psychological and Sociological Research. For more on this
theme by the same authors, see their piece in the magazine TEMAS,
"Una sociedad que envejece: retos y perspectivas",
No. 14, April-June, 1998.
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