C u l t u r a l P e r s p e c t i v e C u l t u r a l a t t it u d e s t o t h e A g e d : a n In d i a n P e r s p e c t i v e A B STR A C T: Institutionalization o f elderly Indians seems to have been increasing with the aging o f the twentieth century. This paper looks at Indian GOUNDEN P, PhD; PUCKREE T, PhD thought and cultural practice with regard to the elderly in time perspective. Departm ent of Physiotherapy, T T . i t i i i i i i i University of Durban-WestvilleHistorically, although the main prescription to cultural practice ana respect fo r the elderly came from the various Indian Scriptures, this was coloured by the specific needs o f each society which changed when these societies were nomadic, settled farm ers or were actively engaged in war. Later other factors like industrialization resulted in a breakdown o f the extended fam ily in which the fa th er no matter how old or productive was the authority figure who demanded respect. This trend was also seen in published literature about the attitude o f other nationalities towards their elderly. Health professionals have been grappling with the role o f health care workers in achieving successful patients outcomes based on attitudes towards the elderly. More work needs to be done on this subject in this country. KEYWORDS: INDIAN CULTURE, ATTITUDES, ELDERLY Technological innovations have led to the information superhigh­way which has made the globe an electronic village. This globalization has resulted in a “one world” concept which allows for encounters with a diversity of cultures and cultural attitudes to life and living. The progressive aging of our popula­ tion as well as the fact that the baby- boom generation has reached the limits beyond middle age has meant that we are now on the era of a larger than ever population of elderly people around the world. First world countries have already focused on all aspects of aging including the cultural attitudes of different age groups of people towards aging as reflected in the plethora of literature on this topic. (Hunter et al, 1979; Collette- Pratt,1976, Seccombe and Ishii-Kunz, 1991, Gonzalez et a/,1997). This paper explores cultural attitudes to aging with special reference to the Indian perspective. A South African Indian person can belong to any of a wide range of cultures which has been and is dependent on religious beliefs. Today’s South African Indian may belong to a Christian, Islamic, Hindu (Gugerati, Hindi, Tamil or Telugu faiths), Buddhist or Sihk faith either by conversion or birth. Culture has been defined as the totality of tools, techniques, social insti­ tutions, attitudes, beliefs, motivations and systems of values which guide the way of life of the members of a group or society (Foster, 1973). An individual’s cultural attitudes are shaped by human migration, war, religion, industrialization and urbanization but with an overriding foundation in the ancient scriptures be they, the bible, the Koran, the Vedic Thirukurral literature or the Pali texts of the Dhammapada of the Buddhist faith. From 3000 BC to 1750 BC the Dravi- dians who were the main inhabitants of India, amongst others, worshipped the Lingam and the Yoni which were male and female fertility symbols respectively. Despite the fact that both the power of the m other and father figures of ferti­ lity were revered, the mother Goddess enjoyed precedence (W heeler, 1966). The Lingam was and still is the uni­ versal symbol for Siva, the Godhead (Hopkins, 1971). In the Dravidian world, the ancient Tamil devotional writings present the same level of unquestioning authority exercised by the heads of the family. An ancient Tamil devotional text presents the Dravidian view at that time. Trans­ lated the verse reads as follows: “One’s father and mother take precedence even before God” (Gaer, 1963). The Aryans who invaded India through the Hindu Kush, a mountain pass in the Himalayas in around 1750 BC settled in India became known as the Indo-Aryans (Bouquet, 1996). These peoples were patriarchal and accorded a place of esteem to the father. These people sub­ scribed to the ancient Aryan or Vedic literature like the Vedas, the Epics, the R am ayana and the M ahabharata, the Ghagavad Gita as well as the Puranas depending on the time in Indian reli­ gious history ( Stone, 1976). The South Indians who are the Dravidians had their own scriptures for example the Thir- rukurral. The esteem afforded to the elderly in early Indo-Aryan and Dravidian culture was also linked to the role of the leader of the family depending on the type of life they led (Puckree, 1989). In the very early days when India was the focus of several invasions, the Indo-Aryans and the D ravidians lived nom adic lives which then progressed to settled fanning communities. In Nomadic communities the value of the male member of the household or CORRESPONDENCE: Prof P Gounden University of Durban-Westville Department of Physiotherapy Private Bag X54001 Durban 4000 Tel: (031) 204-4817 Fax:(031)204-4817 email: lpuckree@pixie.udw.ac.za SA J o u r n a l o f Physiotherapy 1999 V o l 55 No 3 3 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) mailto:lpuckree@pixie.udw.ac.za community, as leader of the clan through adversity by wisdom and strength, could not be underrated. On the other hand in settled communities, where the extended family was large, it was the duty of the female head of the household to provide for her family. In both cases the older members of the family held positions of power which was retained until they were called to rest. The worship of ancestors throughout Indian history also confirms that early Indian thought showed a respect for the elderly members of ones family, clan or community. In the pre-Vedic period c 1750 BC to c 1300 BC the father was the head of the household in a patriarchal society who lived in settled farming communities. The father had absolute authority over a joint family which consisted of a man, his wife, his children, his brothers and their children as well as his parents. However during the Vedic period 1300 BC to 800 BC due to chronic warfare female infants and elderly people who were considered superfluous were exposed (Pinkham , 1967). The Vedic scriptures bear testim ony to the lofty status enjoyed by the father. The ancient story of the lad Naciketas is a typical exam ple o f the esteem and respect in which the father and his pledged work were held. In the well known epic, the Ramayana, the son and heir to the throne, Rama, goes into voluntary exile in order to obey the promise made by his father in a moment of weakness (Dutt, 1898). From 800 to 600 BC during the period o f the Bramanas the male head of the household was in authority. In all cases the North Indian vested full authority in father as the Head of the household in a patriarchal society. The South Indian either placed autho­ rity in the father in the patriarchal clans viz. Kandhs and authority in the mother in matriarchal clan viz. the Santals and the Nairs amongst others (Hunter, 1892). R egardless of w hether authority was given to the father or the mother, the family was an extended one in which great respect was afforded to the head of each household until his/her death. Therefore in both North and South India reverence is accorded to and asso­ ciated with the elderly. From the fore­ going it follows that in old age when authority passes to the eldest son or whoever may be next in line, the retired head is still held in high esteem and not cast aside or neglected. The elderly con­ tinued to live as worthy and respected members of extended families. This cultural thinking was carried with the Indian who was brought to South Africa as an indentured labourer begin­ ning in 1860 to 1910 (Kuper, 1960). However, other factors shaped the Indian persons way of life. Industrialization meant that jobs could only be found at industries which led to the build up of urban societies. The movement away by younger m embers of the fam ilies in search of jobs and accommodation in urban areas led to a break down of the extended family into nuclear families. The roles of members within families were influenced by their productivity and the older generation became a burden to the younger ones. Colette-Pratt reported that a sample of college students deva­ lued old age due to a loss of personal productivity, achievement and indepen­ dence. Both young and middle aged peo­ ple associated negative attitudes towards poor health and death with their devalu­ ation of old age. A significant num ber of people are living in “D harm asalas” and old age homes or day care centres. It may be erroneous to dismiss the institutionali­ zation o f the elderly on the basis of the attitudes of Indians only. Anecdotal evidence shows that selected elderly people in Durban prefer to live in resi­ dential facilities because of the high crime rate in which some o f them are the prime targets. In many cases the elderly are left alone at home when the younger members of the family are gone to work. The Americans who are both ageic and age phobic have developed attitudes towards older persons that prevent them from access to comprehensive health care. Fishman explored the attitudes of physicians, nurses and dentists which may have resulted in the above feelings towards the elderly (Fishmann, 1989). Health professionals are expected to practice their profession on patients from a diversity of cultures. South Africa, is also a virtual boiling pot of cultures just like that in America. It is important for health care professionals who themselves come from diverse cultures, religious beliefs and thoughts that focus on creation or evolution to appreciate the gaps that exist betw een generations about cultural attitudes and practices. The im pact of urbanization, industrializa­ tion, liberation, fam ily structures etc. on the life of the aging and aged person must be understood. Without a survey of actual attitudes and practices one can only speculate on current practices with regard to the South A frican elderly. Even in today’s world, with the exis­ tence of nuclear families, child care is still a burden of the elderly who often are caring for grandchildren, great grand children and even great great grand children. The saying that “as we grow older we move more towards child­ hood” makes this task o f the elderly tak­ ing care of the younger ones a w orth­ while task with the respect afforded to the elderly. This practice is consistent with the em pirical data by Thomas and Yamamoto 1975 which shows that school aged children do not share the general negative attitude towards old age (Thomas and Yamamoto, 1975). As shown by Gonsalez et al (1997) the most important influence on attitude is the individual experience each person has shared with the elderly. Since the South African health profes­ sionals’ basic religious values may have been coloured by a variety of extrinsic factors it may be difficult to predict atti­ tudes without a controlled survey. It is docum ented however that the South African has retained the basic teachings from the holy scriptures but has also borrowed certain western practices that allow him/her to live successfully in a foreign land. However the number of residential facilities for the aged speaks of the changes in practices. W hether the aged live in residential facilities or in modified extended families their health care needs have to be individualized. Health care professionals m ust be taught the impact of attitudes and com m unica­ tion on the success of interventions and an aim to return the individuaLto some degree of independent life. A review of the literature shows that the status of the elderly has not been greatly affected by culture. Although no literature exists on the important aspect 4 SA J o u r n a l o f Physiotherapy 1999 V o l 55 No 3 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) of the effects of urbanization and indus­ trialization on the role of the aged per­ son in society, a correlation seems to exist between the two. REFERENCES: 1. B ou q u et A C 1969 H in d u ism . H u tchinson C o. Ltd, London 2. Collette-Pratl C 1976 Attitudinal Predictors o f devaluation o f old a ge in a m ultigenera- tional sam ple. J G erontol. 31: 193-7 3. D utt RC 1898 T h e Mahabharata, the E p ic o f ancient India. C on d en sed into E n glish verse, London 4. Fishm an S K 1989 H ealth p ro fessio n a ls’ attitudes toward older p eople. Dent. Clin. North A m . 33: 7 -1 0 5. Foster G M 1973 Traditional so c ieties and tech n ological change. Harper and R ow P ub li­ shers, N ew York 6. Gaer J 1963 W hat the great religion s b elieve? D od d m ead and C o., N ew York 7. G onsalez PJL, R odriguez V C , Salazar CJM, Sobrino FR 1997 (W hat do the young think about the old?) Enferm 20: 6 6-9 8. H opkins TJ 1971 T he H indu religiou s tradition. D ic k e n so n P u b lish in g com pany, Inc., C alifornia 9. Hunter K, Kinn MW, Pratt TC 1979 M in o ­ rity w o m e n ’s attitudes about aging. Exp. A gin g R es. 5: 9 5-10 8 10. Hunter W W 1 89 2 T h e Indian Em pire. Sm ith, Elder and com pany, London 11. Kuper H 1960 Indian p eo p le in Natal. U niversity Press, Durban 12. M ahadevan T M P 1960 O utlines o f H indu­ ism . Chetana Publishers, B om b ay 13. Pinkam MW 1967 Women in the sacred scrip­ tures o f H induism . A M S Press Inc., N ew York 14. P uck ree T 1 98 9 T h e e v o lv em e n t in the role, status and education o f the fem ale in India and o f the South A frican Indian fem ale up to 1985, master o f education thesis. U nisa 15. P uck ree R, C h etty TP, Ram lakan S, S im elan e T V S , Lin J 1997 A n evaluation o f the functional status o f a geriatric residential fa c ility in Sou th A frica . D is a b ility and R ehabilitation 19: 552 -5 16. S ecco m b e K M , Ishii-K untz 1991 P ercep­ tions o f problem s associated w ith aging: c o m ­ p a r iso n s a m o n g fo u r o ld e r a g e co h o rts. G eron tologist 31: 5 27 -3 3 17. Stone M 1976 W hen G od w as a w om an. A Harvest/HBJ B ook , Harcourt Brace, N ew York 18. T h om a s E C , Y am am oto K 1975 A ttitu d es towards age: an exploration in sch ool-age ch il­ dren. Int. J A g in g Hum. D ev. 6 :1 1 7 -2 9 19. Vedalankar P N , Shastra navanitam 1981 A co n c ise study o f H indu scriptures, Veda N iketan, Durban 2 0 . W h eeler M 1966 C ivilization o f the Indus V alley and b eyon d . T h om as and H udson, London T h e S o u t h A f r i c a n M e d i c a l A r t s S o c i e t y W I L L BE H O L D I N G I T S 2 3 r d a n n u a l e x h i b i t i o n f r o m t h e 23 A u g u s t 1999 u n t i l t h e 5 S e p t e m b e r 1999 Y O U A R E C O R D I A L L Y I N V I T E D T O A T T E N D T H E O F F I C I A L O P E N I N G T O BE H E L D O N M O N D A Y E V E N I N G T H E 2 3 R D A U G U S T 1 9 9 9 AT 1 8 : 0 0 H R S F O L L O W E D BY A F I N G E R S U P P E R . T h i s w i l l b e h e l d a t t h e i m p r e s s i v e p r e m i c e s o f t h e p h a r m a c e u t i c a l S o c i e t y o f S o u t h A f r i c a i n G l e n h o v e R d , H o u g h t o n , J o h a n n e s b u r g . R o c h e P r o d u c t s w h o h a v e a l o n g h i s t o r y o f i n t e r e s t i n t h e a r t s S P O N S O R T H E A N N U A L E V E N T . E x p o n e n t s o f p a i n t , cl ay, b r o n z e a n d t e r r a c o t t a a r e i n v i t e d t o j o i n t h e s o c i e t y a n d e x h i b i t t w o i t e m s i n a n y o f t h e a b o v e m e d i a . Al l p a i n t i n g s m u s t b e f r a m e d a n d b e r e a d y t o b e h u n g a n d s h o u l d b e h a n d e d i n o n S a t u r d a y 21 A u g u s t b e t w e e n 0 9 : 0 0 a n d 1 2 : 0 0 n o o n . F o r F U R T H E R I N F O R M A T I O N P L E A S E P H O N E : Ri n a E m s l i e at R o c h e P r o d u c t s - Tel n o : ( 0 1 1 ) 9 7 4 - 5 3 3 5 or C h a r m a i n e Le v y - Te l n o : ( 0 1 1 ) 4 8 6 - 3 4 8 7 SA J o u r n a l o f Physiotherapy 1999 V o l 55 No 3 5 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )