Articles dealing with old age in Chinese society tend to portray an idealixed version of traditional upper-class family life. The traditional roles played by the elderly in poor families are neglected, and the contemporary status of the aged in Chinese communities is ignored by most writers. In the summer of 1973 interviews with 78 residents of homes for the aged in Hong Kong suggest that, while traditional roles in this urban community have been undermined, the traditional ethic of filial piety has not been abandoned.

Old Age in Hong Kong Charlotte llcels1

I. Doctoral Candidate in Anthropology, Univ. of Hawaii, Honolulu.

shame to ancestors and parents, to be "unfilial" in Confucian terms, was regarded as the action of a truly inferior person. In ceremonies paying respect to the ancestors, the ritual leader was the senior male of the senior generation. Since he himself would soon become an ancestor, this role seemed especially fitting. But even in ancestor worship there were socioeconomic differences. A wealthy family would be particularly attentive to the ancestors, for the family's present wealth was presumed to be due in large part to the influence of these ancestors. A poor family, by its very poverty, had reason to doubt the ability of its ancestors to aid their descendents, and a poor family did not have the time nor the money to divert these resources into such relatively unproductive ceremonies. Additional factors contributing to the social status of the elderly were the consequences of living in a village (Levy, 1968). First, a son usually owed his own occupation to his father or another close kinsman. In the case of a peasant, he inherited land from his father; in the case of a craftsman, he usually owed his training to his father or other male relatives. His tools, his skills, his clientele, his trading partnerships, all were owed to his senior kinsmen. As long as he remained in his own village, a tremendous sense of obligation insured that he would do his best to live up to his filial responsibilities. Second, the forces of public opinion in a small, stable village where everyone knew everyone else made life difficult for any young man who chose to defy convention by neglecting his parents. He would find it difficult to obtain a wife or to maintain his business relationships. He would find his opinions ignored in public discussions and would either have to reform or attempt to survive as a social isolate. While a young person might have been able to survive as a

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Descriptions of the social position of the elderly in traditional Chinese society emphasize the prestige associated with old age (Doolittle, 1966; Lang, 1946). Becoming a village elder entitled one not only to an extra share of meat at all ritual feasts but also to the unqualified respect of one's juniors. How closely reality approximated the ideal was in fact largely determined by two variables: wealth and kinship. The senior male of a family, if wealthy and literate, continued to exercise great authority as long as he remained in reasonably good mental health, and the senior woman retained similar authority in her own sphere. A literate person could make valuable contributions to a family's enterprises long after his body had passed its prime. For those individuals whose contributions were determined by their physical capabilities, the decline in strength and endurance which accompanies aging meant erosion of actual power. However, even in poor families, as long as an individual could perform some useful economic function, e.g., tending children and thus freeing other adults for more productive purposes, his position was still secure. The role of ancestors in traditional Chinese culture was also associated with the relatively high status of the aged (Hsu, 1971; Levy, 1968; Yang, 1970). In many societies, ancestors take on a malignant aspect, scrutinizing the behavior of their descendents and wreaking punishment for even minor infractions (e.g., Mead, 1962). Chinese ancestors, however, were usually perceived as benign and helpful, although they too were concerned with the morals of their juniors. Good behavior was seen as owed to the ancestors; bad behavior would bring shame to them and cause them a loss of face in the spirit world. To bring

A Description of Hong Kong Hong Kong, a British Crown Colony of over four million people, lies 90 miles southeast of Canton, the largest city in the adjoining Chinese province of Kwangtung. The Chinese imperial government ceded parts of Hong Kong to the British government in the middle of the 19th century following military action by British merchants and soldiers. The remaining predominantly rural parts of Hong Kong, now known as the New Territories, were leased from China in I 898. The present population of Hong Kong is 98% ethnically Chinese. The remaining residents are primarily European in origin. Despite the fact that much of Hong Kong has been under the control of a British Governor for over 130 years, the Chinese were left to their own devices in matters of customs and social welfare. The British preferred to concentrate on economic matters and, except for preserving public order, were little concerned with matters internal to the Chinese community until after the Second World War. In the period between 1945 and the early 1950s, the government of Hong Kong was forced to direct its attention to matters of social welfare, particularly to housing. This reorientation was a direct consequence of the civil war then raging in China from which hundreds of thousands of refugees fled. The phenomenal population increase, from an estimated 600,000 to over 3,000,000 by 1961, was accompanied by a shift in Hong Kong's economic role from that of a commercial to a manufacturing center. This economic shift made it possible to absorb the migrants' labor power. Such migration was not new to Hong Kong. For most of this century thousands of Chinese had migrated back and June 1975

forth between Hong Kong and their home villages in Kwangtung. Only after 1949 was this traffic severely restricted, although even today many Hong Kong Chinese return to their home villages at Chinese New Year. Given such a history of migration, it is not surprising that a majority of Hong Kong's elderly are not locally born. Although most Hong Kong residents have close kin living in Hong Kong, some have left all their relatives behind in China, and just as in traditional times, these familyless individuals live a precarious existence. According to data provided by the Census and Statistics Dept. to the special Interdepartmental Working Party on the Future Needs of the Elderly (1973), 92,239, or 3 1 % of all old people (aged 60 or more) were still gainfully employed during the census period of 1971. Of these working old people, 86,667 were working full-time, and only 5,572 were working part-time, at least 15 hours a week. , A t present there is no contributory social security system in Hong Kong, nor, except in the case of the government and some of the larger firms, are there employer-sponsored pension schemes. The incentives to continue employment are obviously great, and the inability k> continue work was regarded by my elderly informants as the ultimate defeat of old age. Household Composition Since children are regarded in Chinese society (Mitchell, 1972), as well as elsewhere (Fawcett, Arnold, Bulato, Buripakdi, Chung, Iritani, Lee, & Wu, 1974), as the major source of protection in old age, the number of childless elderly in a community offers some hint of the number of potentially needy elderly. According to the 1971 census, of the old people in Hong Kong who have been married, only 10%, or 27,835 individuals, had no living children. Adding this number to the 15,139 who had never married yields a total of 42,974, or 15% of all old people in Hong Kong having no living children. Those aged persons who did have living children had an average of two, although these children were not necessarily living in Hong Kong. Some children had been left behind in China, and other children have migrated to Canada or the United States from Hong Kong. According to data supplied to the Working Party, in 1971, 123,066, or 42% of the aged in Hong Kong were heads of domestic households, of whom 28,009 were living alone and 23,285 were living with only one other household mem-

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social isolate, a solitary old person would have lived a very precarious existence. Among the options available to such a familyless aged person were: appealing to the ancestors' fund of his lineage (a corporate group consisting of the male descendents of a common ancestor), but such a fund implies a wealthy lineage; appealing to the village headman; begging; or joining a Buddhist or Taoist monastery. My Hong Kong informants, most of whom grew up in rural Chinese villages, saw begging as the most likely alternative. This description relates to the ethic of traditional or pre-1900, village China, but what are the circumstances today in a modern urban setting?

ber. Among the rest of the aged population, 28,092, or 10% were spouses of the household head, and I 14,248, or 39% were otherwise related to the head of the household. Only. 9% or 23,282, were living with unrelated persons or in institutions. These figures indicate a high rate of common residence, although they cannot be construed so as to reveal the degree of intimacy or satisfaction accompanying this sharing.

Two residents of a Buddhist home for the aged help prepare a meal.

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The kitchen of the same Buddhist home.

The dining room of the same Buddhist home.

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Social Welfare Policies Official government involvement in social welfare activities can be dated back to 1948 when the Social Welfare Office was established as a specialized subdepartment of the Secretariat for Chinese Affairs. Its early responsibilities included protecting women and girls and dealing with suicide and repatriation cases. The Social Welfare Office became an independent department in 1958 and gradually expanded its services to include family counseling, group and community work, rehabilitation of public offenders, and public assistance. According to the Annual Departmental Report for 1972-1973, the total number of public assistance cases for that period was 24,484. The actual number receiving assistance at the end of March, 1973, was 19,283, compared with 13,509 at the end of March, 1972. Of these 19,283 cases, 10,043, or 52.1%, involved elderly recipients. As of April, 1972, the maximum public assistance payment to an individual was raised from $70 to $1 10 a month —at an exchange rate of approximately $5 HK to $1 US, this amounted to a raise of from $14 to $20 US monthly. In addition, as of June, 1973, an individual of 75 years or more became eligible for a nonmeans-tested monthly payment of $55 HK above any public assistance already received. Both of these payments are increased periodically to allow for rises in the cost of living. In some cases an individual can also receive a small rent allowance or special dietary allowance. A major expense incurred by the elderly is that of medical treatment. In Hong Kong such costs are nominal, since certain services are government-subsidized. For example, in government outpatient clinics, there is a charge of $1 HK per visit, and this includes the cost of medicine, X-rays, and laboratory tests. Consultation at a specialist clinic also costs $1. There are no charges for patients attending tuberculosis, social hygiene, or leprosy clinics. Tuberculosis remains Hong Kong's major community health problem, with 0.8% of the population suffering

from active pulmonary tuberculosis requiring treatment. Males are affected nearly twice as often as females, and the disease is particularly common among elderly men. Government hospitals charge between $2 and $6 HK daily according to the diet supplied. The services of such hospitals are in great demand and corridors are usually overflowing with patients. There are also private hospitals, some of which are essentially charitable institutions, and

others of which charge fees which put them well beyond the reach of the majority of the population. The above medical costs refer to treatment by Western-trained practitioners at governmentrun clinics. Visits to traditionally trained Chinese physicians are not government-subsidized nor is the cost of traditional herbal remedies. Judging from the number of herbal shops in Hong Kong, there continues to be a great demand for traditional means of treatment.

The lot of the familyless older person in traditional China was difficult. As noted, a traditional alternative was to enter a Taoist or Buddhist monastery in one's declining years. This frequent association of older people with monastic communities gradually led in some cases to the development of auxiliary homes for the aged. As Christian missionaries penetrated China, they too became concerned with isolated individuals. This legacy is operating in Hong Kong today. As of the summer of 1973, there were 21 homes for the aged listed by the Dept. of Social Welfare. Of these 21 homes, 19 were visited by the author. The 2 not visited included I home enrolling only the aged blind and another enrolling aged nuns. Of the 19 homes, only I was directly sponsored by the Dept. of Social Welfare in conjunction with two other government departments and eight voluntary agencies. Some of the homes received direct financial assistance in the form of subsidies from the Department. Monthly payments were also made to the homes on behalf of residents referred as clients of the Department. All of the homes, with the exceptions of I run by a rural committee and another sponsored by a charitable group of business and professional men, June 1975

The increase in the number of such homes—of the 19 homes visited only 3 had been established prior to 1955—prompted policymakers to question the extent to which Chinese families might be disregarding filial responsibilities. Yet demographic data alone suggest that a changing population pyramid could well be the reason behind the proliferation of homes for the aged during the 1960s. In 1961, the percentage of people aged 60 and over was 4.84, and aged 65 and over, 2.81. These figures contrast with 1971 percentages of 7.45 and 4.51, respectively. One reason for the growing proportion of the elderly is a drop in the birth rate from 35.0 per 1000 in 1961 to 19.7 per 1000 in 1971. Two other factors contributing to the increase are a rise in life expectancy and a decrease in the rate of immigration of young adults. Residents of Homes for the Aged In the spring and summer of 1973, there was considerable public concern about the elderly. The government itself was waiting for a report from a special Working Party on the Future Needs of the Elderly. The Hong Kong Council of Social Services, the coordinating body for most of the voluntary agencies in Hong Kong, had created a committee to look at both community and institutional services to the elderly. Given this atmosphere of awareness, the author had little difficulty in obtaining permission to visit the various homes and to talk with supervisory personnel. After visits to the various establishments were completed, 6 were selected for revisiting in order to interview some of the residents to obtain biographical data. The 6 homes revisited included I large home run by the Little Sisters of the Poor, I Buddhist home for men, I Buddhist home for women, I home for men run by a Christian agency, I home run by a rural committee, and I that might be classified as a unit of sheltered apartments. All of the homes, with the exception of that run by the Little Sisters of the Poor, require new admittants to be free of infectious diseases, capable of selfcare, and usually in serious economic difficulty. A total of 78 residents, 33 males and 45 females, was interviewed. This sample does not represent a cross-section of the elderly population of Hong Kong nor even of the residents of old people's homes. First, less than 1.5% of the elderly population of Hong Kong is institutional-

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Homes for the Aged Given the pressure for hospital care for acute illnesses, it is not surprising that there is practically no provision for long-term care. For elderly patients who have been hospitalized, a very serious problem may exist upon discharge, namely, where to go for recuperation. Homes for the aged are exactly what the name implies; they do not function as nursing homes. In fact, most such homes will not even admit an old person unless he is capable of self-care, although the two largest homes, both run by the Little Sisters of the Poor, are exceptions to this policy. Other homes readmit their own former residents upon hospital discharge.

are supported by religious organizations, either Christian, Buddhist, or Taoist.

restrictions on mobility and diet, and maximal freedom to engage in recreational and productive activities. The use of the institution's facilities by other groups, e.g., Bible study classes, also contributes to a sense of participation on Of the 75 individuals from whom I sought the part of the aged residents. One of the major problems faced by some of information on kin, over one-third (26) had no kin of any kind in Hong Kong at the time of the residents is mismatching with a particular entry into the home. Of those respondents who home. For example, several people in vegetarian had any relatives (49 respondents), 3 I lived with Buddhist homes are neither vegetarians nor them immediately prior to entry into the home. Buddhists, yet they must subsist on the regulaAdditional comments suggested that economic tion diet and participate in prayers. These undifficulties in the households were a prime factor fortunate individuals were often in a deprived motivating entry into a home for the aged. The state outside the home and required immediate following composite life history is representa- placement, i.e., they could not afford the time tive of that of many of my informants. on the waiting list necessary to be admitted to one of the more satisfactory homes. An extreme I was born in a poor village in Kwangtung. When I case of mismatching is that of a highly educated was 20, my husband and I migrated to Hong Kong in search of work. When the Japanese came, life was refugee who found himself placed in a home in very hard, and my husband died. After the war, I which many of his coresidents were former worked as an amah (domestic servant) for several beggars with low standards of personal cleanlifamilies. I lived with my last employer's family for 8 ness. This man ran away from the home 15

ized, and this figure includes those in prisons and hospitals as well as homes for the aged. Second, the residents interviewed were more likely to be those in good health and possessing extroverted personalities.

Depending upon previous circumstances, the residents have quite varied perspectives on their present situations. Some are grateful for the opportunity to have three meals a day and a bed to call their own. One woman described her residence (one of the better ones) as a "little heaven." Others are humiliated at having to spend their final years in an institution. Two or three respondents confessed that they had ceased writing letters to relatives in China because they did not want them to know of their situation—it was better to be presumed dead. That the attitudes toward particular homes vary greatly is apparent from the number of people on the individual waiting lists. One home with a waiting list of 200 has had no vacancy for the past 4 years, while another is operating at only 60% of its capacity and has no admissions pending. Most unpopular are homes associated with Buddhist temples. These institutions are characterized by mandatory vegetarian diet; often compulsory prayers, severe restrictions on freedom of movement, lack of access to commercial areas, minimal recreational activities, and prohibitions on the making of handicrafts for profit. Most popular are homes located near bustling commercial districts (near kin and former associates in many cases), with minimal

The difficulty of ascent to a Taoist home for the aged is clear from this picture of the unprotected stone steps which lead to the entrance.

Part of a major Taoist temple complex with which a home for the aged is associated.

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years, but then they emigrated to Canada. Then I went to live with my daughter, but it was very difficult. She and her husband have six children, and I was very uncomfortable there, so I decided to come to a home for the aged.

times, but was returned by the police each time. Yet in another part of Hong Kong, there is a home in which the majority of the residents have attended at least secondary school, and some have even graduated from college. These men, all refugees, practice calligraphy and hold study sessions weekly.

Not only poor, old people need help. The rich and not-so-rich, old people also need help. The younger generation hate the very sight of them. Servants are difficult, if not impossible to find. They can no longer cope for themselves. The solution to the problem is for the Government/Private Sector to run Retirement Hotels charging from luxurious hotels rates to a nominal fee depending on the style and service. The difference between such hotels and ordinary hotels lies in the presence of a doctor, nurse, or social worker.

June 1975

References Dept. of Census & Statistics. Hong Kong Population and Housing Census 1971. Government Printer, Hong Kong, 1973. Dept. of Social Welfare. Annual Departmental Report 1972-1973. Government Printer, Hong Kong, 1973. Doolittle, J. Social life of the Chinese. Ch'eng-Wen Publishing Co., Taipei, 1966 (originally published in 1865). Fawcett, J., Arnold, F., Bulato, R. A., Buripakdi, C, Chung, B. J., Iritani, T., Lee, S. J., & Wu, T-S. The value of children in Asia and the United States: Comparative perspectives. East-West Center, Honolulu, 1974. Hong Kong 1974. Report for the Year 1973. Hong Kong Government Press, Hong Kong, 1974. Hsu, F. L. K. Under the ancestors' shadow. Stanford Univ. Press, Stanford, 1971 (originally published in 1948). Lang, O. Chinese family and society. Yale Univ. Press, New Haven, 1946. Levy, M. J. The family revolution in modern China. Atheneum, New York, 1968 (originally published 1949). Mead, M. Growing up in New Guinea. William Morrow, New York, 1962 (originally published in 1930). Mitchell, R. E. Family life in urban Hong Kong. Orient Cultural Service, Taipei, 1972. Report of the Working Party on the Future Needs of the Elderly. Services for the Elderly, 4th Rev., Hong Kong, April, 1973. South China Morning Post, Hong Kong, July 21, 1973. Yang, C. K. Religion in Chinese society. Univ. of Cali-

fornia Press, Berkeley, 1970 (originally published in 1961).

A new clinic on the grounds of a Buddhist home for aged women.

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Conclusion Neither the statistics available from government departments nor the information gathered during the interviews suggests that the people of Hong Kong are about to abandon the senior generation. Those elderly who are presently in needy circumstances are disproportionately those who either have no surviving close relatives in Hong Kong or whose close relatives are so economically limited themselves that they cannot offer adequate assistance. Nevertheless, the traditional cultural supports which previously protected the status of the aged have been almost completely undermined. Literacy is no longer the privilege of the few. Young people are no longer so dependent on their parents for a share of the family's land. The opportunities for employment have lessened the sense of obligation a young person felt toward his elders. The great residential mobility which occurs in Hong Kong has nearly eliminated the power of public opinion as a restraining force. According to Mitchell's study (1972) on family life in urban Hong Kong, ancestor worship is on the decline, and an increasing proportion of both the old and the young do not expect to be members of three-generation households when they are old. These changes in attitudes have already resulted in unhappy letters to local newspapers such as this one to the South China Morning Post (1973).

Whether this view reflects the situation of only a minority of the aged or whether it is prophetic of the fate of a majority remains to be seen.

Old age in Hong Kong.

Articles dealing with old age in Chinese society tend to portray an idealixed version of traditional upper-class family life. The traditional roles pl...
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