Understanding Aging Issues in Indonesia

NAPSIYAH, Siti
School of Social Work
McGill University, Montreal

August 2005

A thesis submitted to McGill University in partial fulfillment of the requirements of the

degree of Masters in Social Work

Napsiyah 2005
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 Abstract

This study used combined methods of observations, interviews and document

analysis to understand issues related to aging in Indonesia. The study describes relevant

policy and practices for older pers ons in Indonesia, and discusses major social issues of

poverty, the need for social security, and ambivalent views of older people in Indonesian

society. While the Social Department Affair (Depsos) has pioneered in providing

initiatives for older persons, the benefits of these supports are often limited (e.g, formaI

sector, urban areas). Complexities of the emphasis on family caregiving, constrained

govemment budgets, and social stigma (e.g., "the last priority") mean that older people

do not necessarily receive appropriate support from govemment and society. The role of

religion, culture and gender in shaping aging issues are specifically discussed. It would

seem that improving the lives of oIder people in Indonesia requires a social work

approach drawing on outside examples while maintaining local tradition.

 Abstract

Cette tude a utilis les methodes d'observation, d'entrevue et d'analyse de document

afin d'analyser le problme de vieillissement en Indonsie. L'tude dcrit les politiques et

pratiques pertinentes pour les ans en Indonsie et discute des problmes majeurs de

pauvret, le besoin pour l'aide sociale et les diverses perceptions de gens gs dans la

socit indonsienne. Alors que le Depsos a entrpris l'innovation de fournir des

initiatives pour les ans, les bnfices de son appui sont souvent limits (ex. le secteur

formal, les rgions urbaines). Les complxits de l'emphase sur les soins de famille, les

budgets gouvernementaux limits, et les stigmates sociales (ex. 'la dernire priorit') font

que le gouvernement et la socit ne fournit pas ncessairement aux gens ags un appui

qui leur convient. L'influence de la religion, la culture et le sexe sur les problmes de

vieillissement est galement discut. Il semblerait que pour amliorer la vie des ans en

Indonsie il est ncessaire d'adopter un point de vue inform par des exemples externes

tout en prservant les traditions locales.

 Acknowledgments

1 would like to convey my deepest gratitude to my supervisor, Dr. Amanda Grenier, for
her intense assistance and guidance for this study. It would not have been completed
without her patience in advising this study. My deepest appreciation and love also goes to
my husband, V.M. Ariefuzzaman and my son, Fendry A. Ariefuzzaman. Their love,
patience, support, input, and companionship have provided a great "spirit" to finish this
study.

Special thanks to: CIDA (Canadian International for Development Agency) for its
financial support during my study at McGill University; IISEP (IAIN Indonesian Social
Equity Project), particularly Wendy Allen, Lori, Susy, Jen, and Kak Ani for their
administrative assistance during my stay in Canada; DEPAG (Department Agama) Prof.
Dr. Azyumardi Azra (rector of UIN "Syarif Hidayatullah" Jakarta) for their facilitation
and support to study at McGill University; and the School of Social Work, Mc Gill
University, especially Prof. Estelle Hopmeyer, Lillian, Maria, aIl my professors, teaching
assistants, staff and graduate students in this program. They have provided me with
wonderful assistance, information, knowledge, and support; and for my editor, Sara
Collings, for her patience, assistance, and help with editing my thesis.

1 would like to extend my gratitude to aIl my friends at the Indonesian Student

Association (PERMIKA) of McGill University. They have supported my two year long
study period with happiness, togetherness, and care. 1 would also like to thank aIl the
members of the Indonesian community in Montreal, Ottawa and Quebec for their support
and encouragement during my stay in Canada.

My deepest thanks and respect goes to my parents and family in Indonesia. Their love
and prayer have greatly strengthened my motivation to finish this study.
 UNDERSTANDING AGING ISSUES IN INDONESIA
Table of Content

CHAPTER 1: INTRODUCTION............................................... 1
1. Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1
1.1. Personal Rational. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2. Literature Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.1. Literature on Indonesian Aging.......................................... 5
2.2. General Gerontology Literature.......................................... 7
2.3. Demographics.............................................................. 8
2.4. Factors Related Demographic Changes................................ 10
2.5. Aging in Indonesia........................................................ Il
3. Research Topic/Research Aim.......... .......... ............................ 12
4. Research Question....... ..... ... ..... ..... ... ..... ... ... ... .... .... .... ........ 13

CHAPTER 2: METHODOLOGY................................................ 14
1. Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2. Data Collection Methods......................................................... 15
2.1. Participant Observation.................................................... 16
2.2. Semi Structured Interview..... ........... ...... ......... .... .... ..... ....... 18
2.3. Document Analysis. ... ....... ........ ..... ... ... ... ... .... .... ..... .... ...... 20
3. Data Analysis.. ... ...... ... ... ........ ....... ... ............... ..... ....... ......... 21
4. Ethical Issues....................................................................... 22

CHAPTER 3: MAJOR SOCIAL PROBLEMS, SOCIAL POLICIES AND

SERVICES FOR OLDER PEOPLE IN INDONESIA ............................. 25

1. Social Security and Poverty ..................................................... 25

1.1. Social Security for the Elderly .............................................. 25
1.2. Poverty and the Elderly ....................................................... 30
2. Indonesian Social Policies for Older Pers ons ................................ 33
2.1. The Elderly Welfare Act (UV NO. 13/1998)................................ 33
2.2. The National Commission for OIder People (Komnas Lansia)........... 36
3. Type of Services for Older People in Indonesia.............................. 38
3.1. State Base Services........................................................ ..... 38
3.2. Community and Religious-based Services .... .............................. 40
3.3. Public-Based Services...................................................... 42
3.4. Discussion..................................................................... 42
4. Summary............................................................................ 44
CHAPTER 4: INTERPRETATION: HOW CULTURE, RELIGION,
AND GENDER SHAPE AGING IN INDONESIA ........................... 45

1. Defining Old Age..................................................................... 45

2. Culture and Aging....... ........ ........ ............. ... .............. .... .... ....... 47
2.1. Family and the Elderly......................................................... 48
2.2. Community and the Elderly ................................................... 51
2.3. The Position of "Elderly" in Indonesian Society........................... 52
3. Religion and Aging.................................................................. 55
3.1. The Importance of religion in Aging. . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . 56
3.2. The Misinterpretation of Religious Practice ................................. 60
4. Gender and Aging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
4.1. Gender and the Patriarchy System............................................. 61
5. Summary.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 65

CHAPTER 5: SOCIAL WORK APPROACHES FOR OLDER PERSON'S IN

INDONESIA................................... ...................................... 66

1. Social Work Perspective on Aging................ ... ... ... ........ .... ..... .... 66
2. Possible Approaches for Social Work Intervention in Indonesia. . . . . . . . . . . . 68
2.1. The Micro-Mezzo-Macro Model of Social Work ..................... 68
2.2. The 'Clinical' Approaches for Social Workers in Indonesia ......... 75
3. Elderly Poverty, Social Security and the Role of Social Work in Indonesia 77
4. The Role of Social Work for the Rural Elderly Population ................. 80
5. EIder Neglect (Abuse) and the Role of Social Work in Indonesia......... 83
6. Summary........................................................................... 85
CHAPTER 6: DISCUSSION AND CONCLUSION.............................. 87
1. Conclusion and Discussion......................................... 87
2. Limitations ofStudy and Recommendations........................... 91

APPENDIX
REFERENCES
 CHAPTERI

INTRODUCTION

1. Background
The ageing of populations is now a global phenomenon. Since early 1970s,

Indonesia is in a period of demographic transition. In 1971, Indonesia' s population was

relatively 'young', however, from that time on the percentage of the elderly has increased

each year. By 2020, it is predicted that the number of the elderly will increase

significantly. The United Nations Census Bureau predicted that the percentage of

Indonesians over the age of 60 would rise from 7 to 8 per cent in 2025 (Kreager, 2003).

Surprisingly, it is predicted that by 2010, the aging population will increase to 9.58 per

cent, and it will make up to 11.2 per cent in 2020 (Minister of Social Affairs, 2002).

There is no doubt that the processes of social and economic change are also

affecting Indonesian society. In particular, the elderly are challenged by changes in two

areas of life: the economy and the family. Changes to the economy mean that

globalization is accompanied by increased urbanization, industrialization and an increase

in the services sector of the economy. Furthermore, the impact of urbanization and

industrialization is likely to be accelerated by the process of globalization of the economy

and the globalization of communication. Over time, this may mean a reduction of the size

of the family and families may take less responsibility for their elderly members. At the

national level, this could mean an increased sense of insecurity for the elderly because

there are few and limited state supported programs of insurance and assistance for them.

Tan (2003), in his study of aging issues in Asia, postulates that from a

sociological point of view, a rapidly ageing population will give rise to a number of

1
pressing problems. One of the most important is the lack of financial well-being for the

aged, but other problems include inadequate housing and eIder care. Although Tan's

study focuses on the Singaporean society, l believe that many of the similar social

problems face the aging population in Indonesia. Moreover, the problems of older people

in Indonesian society are "invisible". Due to various factors, such as the impact of long

lasting Dutch colonialism and imperialism, older people are viewed as the "last priority"

or as a "non-targeted group".

This study will examine agmg Issues m Indonesia in order to explore their

relationship to social policy and social work practice. In this chapter, l will present an

overview of my personal connection to this topic. From there, l will provide a review of

the literature that pertains to my study. Finally, l will describe the general research

problems and questions that guide this project.

1.1. Personal Rational

l graduated from the State Islamic University (Universitas Islam Negeri "Syarif

Hidayatullah") Jakarta, Indonesia at the Department of Dakwah and Communication. l

am completing a Masters Pro gram at school of Social Work at McGill University, which

is sponsored by CID A (Canadian International for Development Agency). This

programme involves an agreement between the Indonesian government (through MORA

and UIN)) and the Canadian government (through McGill University) to work together to

create "social cohesion" and ''political stability" in Indonesia. The strategy to achieve

these goals is to strengthen CIDA scholarship receivers (including me) to become

llAIN Indonesia Social Equity Project (nSEP) is the continuum ofprevious project, ICIHEP (lndonesia-
Canada Islamic Higher Education Project) which has been conducted in two phases.

2
plOneers and motivators for the improvement of the educational system in the UIN

institution. As a result, we will strengthen our community capacity building and

community development in our society from the grass roots level.

At the school of social work at McGill University, 1 have gained valuable

knowledge about how to deal with various social issues, and more importantly to me how

to promote a quality life for persons receiving social services; inc1uding particular

vulnerable persons such as older people. My interest in social gerontology came from my

experience in the field placement at CLSC Rene Cassin, which is considered as a center

for Social Gerontology in Quebec. 1 worked at a Department called "60-Plus" in the

Caregiver Support Center (CSC) and Home Care. This experience gave me a broad

understanding of how to work with aging populations. Moreover, it invited me to think

about the aging issues in my own country and to examine how culture and practices

shape aging in our society.

1 have several other personal reasons for my interest in ageing issues in Indonesia.

First, 1 recognize that research on ageing issues in Indonesia is still rare or minimal,

compared to other social issues such as street children, poverty, and the like. It is not seen

as a "sexy topic" among social scholars in Indonesia. Second, 1 want to know more about

the specifie problems or issues related to aging in Indonesia. Third, 1 believe that starting

to work on ageing issues is one of the strategies to combat the enormous social problems

in Indonesia. Fourth, 1 believe that this study will challenge my knowledge, experience,

and my academic tradition.

As a Moslem, 1 am interested in the influence of religion, specifically Islam,

(which is the religion most followed by approximately 80% of the Indonesian

3
population), regarding its influence on elderly people and how the eIders perceived

themselves. In Islam, to obey and take care of the elderly is a family's (sons and

relatives) responsibility. The Qur'an, for instance, says that children have to respect their

parents in every wal. This is reflected in the very basic guidelines for daily interaction,

which explain that a Muslim should not even be "rude" to his or her parents. In addition,

there are a number "Sunnah" and "Hadist" (the sayings and behaviours of the Prophet)3

which state that it is the parent's (elder's) right to be respected and to be cared for by

their children and family as a repayment of their past investment in caring for the young.

So, the question is what is the role of religious teaching methods for family in caring for

the elderly?

Second, as a woman l am interested in encouragmg my society's system to

provide care for its senior citizens. Yet, l feel that our system is patriarchal and reflects

the religious belief that to obey the male (such as husband, brother, and father) is a

female's (wife, daughter, and sister) responsibility. l wonder how gender roles play out in

our daily relations with the elderly. It would seem that as in the West, caring is a

"gendered" issue where women provide most care within the home. Renee, l also wonder

is there a gender difference between older women and older men; are women m

Indonesian society more vulnerable (socially, physically, financially, and socially)?

Third, as an Indonesian student, l have been taught by my family that caring for

our older people is the 'younger' peoples' obligation. The family (both extended and

nuc1ear) has the responsibility to prote ct their eIders from harm and neglect. Our

communal value system teaches us to help the poorest of the poor among the eIder people

2 See Qur'an AI-Isra':23 "Your God commended you to worship the only him and ohligated you to care for
your parents"
3 Qur'an and Hadist are the primary sources for the Islamic teachings.

4
in society. Furthennore, our culture encourages us to have a 'mutual assistance' (gotong

royong) spirit in order to help the vulnerable elderly people in the neighbourhood, as

there is a belief that it is a blessing to have and take care of an elderly at home.

Therefore, it is considered a "taboo" and shameful in our society to put elderly people in

the "Home for the Aged", in this case, the society will 'blame' their sons or the extended

relatives for neglecting their eIders. Moreover, in our culture, we believe that "home" is

the best place to provide care for elderly people. While this preference for home is not

different from the Western societies, the dynamics of the meaning of the family's

responsibility seem to be different.

In contrast, while studying III a Western society, l observed that there is a

different attitude towards aging in society: they value the independence of eIders in

society. So, many oIder people live al one or live in nursing homes for the rest of their

lives. Additionally, l have also observed that the government has more social programs

for the elderly than the Indonesian government has. Thus, my exploration of aging in

Indonesia inc1udes a reference to and a contrast with the Canadian patterns where

appropriate. In this study l will try to gain insight about the kinds of services, social

policies, and life-styles from the Canadian context that can be applied to Indonesian

society.

2. Literature Review
2.1. Literature on Indonesian Aging

There are several identified problems faced by the Indonesian elderly. The first

and foremost problem is poverty, which has become the main challenge faced by the

elderly (see Dung Do-Le, & Raharjo, 2002; Setiabudhi, 2003). OIder people in our

5
country are socially excluded from the 'productive world' or the 'labor market'. This

problem has been compounded by the unresolved 'krismon' (or monetary crisis began in

1997). For example, those with a civil servant pension4 must share it with their spouse,

daughter, grandchildren, or whole families. However, most elderly do not have the right

to a pension, as it is only eligible to those who have worked as civil servants or in the

state's corporation, and are, therefore quite poor.

The second issue facing the elderly in Indonesia is that due to poverty there is a

potential risk of poor health. This is of course worsened by the fact that biologically,

body functions tend to decline with age. This seems that age naturally has a strong

correlation with health problems, which are significantly more common in older age

groups. For instance, the elderly can suffer from Alzheimer disease, dementia, diabetes,

and other chronic diseases. Nazara (2003) claims that one of the urgent problems ofaging

population is the health care expenses. However, he finds that neither govemment nor

private sectors has a specialized health care system for the aging population in Indonesia.

Limited coverage is available for public sector employees, which is only a small

percentage of the population. Nazara (2003) points out that health care system for the

poor and the vulnerable aging population is an immediate necessity. Otherwise, Indonesia

will face difficulties to cope with the rising medical expenses for the elderly.

The third issue faced by the older people in Indonesian society is the lack of

access to social services (especially for those who live in rural areas). This is because the

services provided by the govemment are too "urban biased". In other words, only 2 per

cent of the aging population has access to the insurance based social services 5 These

4 The pension benefits only for those who works in the formai sector, large companies, as weIl the military.
5 This may mean that there is a greater risk of neglect for those in urban or city centres.

6
services include access to the Home for the Aged or Panti Social Tresna Werdha or panti

jompo6. As 1 have mentioned, Social insurance coverage only provides for the elderly

who have worked in the formaI sector (such as civil servants). The people who have not

worked in this sector, or without a family support system, and who live in rural areas,

face a very different situation. Therefore, 1 would suggest that the problems facing eIders

in Indonesia must be contextualized within the general study of aging.

2.2. General Social Gerontology Literature

The experience of ageing is influenced by an interaction of physical, mental,

social, and cultural factors. How ageing is viewed by society also reflects the two-sided

nature of aging: it has advantages and disadvantages. The two faces of aging are reflected

in society's ambivalent treatment of older people with respect to social attitudes, social

policy, the literature on ageing, and theories about ageing and older people (Atchley &

Barush, 2004). On the one hand, the society hears messages about wisdom or healthy

aging, but there are also strong messages of decline associated to older people, such as

weak, frail, and dependent. In addition, the perception of old age as a problem is

mediated through values and the political-economic structure that produces specifie

relationships between the state and families (Hokenstad & Midgley, 1997).

While academics often identify trends, and therefore focus on commonalities, it is

important to understand that there is tremendous diversity in the aging experience. The

difference across gender, class, race, culture, and social economic status (SES) is also

important. For example, not only do women live longer than men, but the aging

6 The first one is formai and the second is the informai language for the home for the aged.

7
experience is also very different for women. For example, oIder women are far more

likely to live alone, be po or, and be institutionalized in later life (Chappell et. al., 2003).

2.3. Demographies
This section will describe the ways that researchers have used the demographics

of aging in Indonesia in order to understand the growing elderly population. Chappell et.

al. (2003) present three ways of classifying the aging population: Percentage aged 65+,

median age, and dependeney ratio. The most common measurement of population aging

is the percentage of the population aged 65 years and over. By mIe of thumb, a

population in which people of age 65 years and over constitute at least 10 percent is

deemed to be old (Chappell et. al, 2003). Nazara (2003) states the proportion of the

elderly in Indonesia is accelerating. These eIders account for 7.2 percent of the total

population in 2000. However, he also mentions another report stating that in 2004 the

elderly contributed to 7.3 percent of the total population (lndonesian country report 2004,

BKKBN). This statistic suggests that in the near future, the number of elderly people over

65 will increase 'rapidly' (up to 10 percent) since there is an increase in the population's

life expectancy (70 for women and 65 for men) and there is a decline in both mortality

and fertility rates in Indonesia.

Another single measure of population aging is the median age of the population.

The median age is the age at which one-half of the population is older and one-half is

younger. As the median age increases, the population is considered to be aging (Chappell

et. al., 2003). In Indonesia, the median age is 26.1 years. For females it is estimated to be

26.6 years and for males it is expected to be 25.7 years 7

7 From http://worldfacts.us/lndonesia.htm

8
 The last measure is the dependency ratio or the "dependency burden". The most

frequently used dependency ratios define the total population of those who are "working

age" (between 15 and 64 years), as non dependent ages (Chappell et. al., 2003). Data

from the Indonesian Department of Social Affairs demonstrates that the number of

elderly people (above 60 years old) has cUITently reached 12 million people in Indonesia.

By 2030, the percentage of the population that is older than the CUITent retirement age (55

years) and the old-age dependency ratio is expected to be twice as high as the CUITent

level. According to the World Population Prospects (2000 Revision), the total

dependency rati08 in Indonesia will be 48 percent in 2010, with an old age dependency at

9 percent. Dung Do-Le & RahaIjo (2002) report that the aged dependency ratio was 6.9

percent in 1995 and it will increase to 10.1 percent in 2005.

Data from the V.S. Census Bureau (1992) shows that the ageing population in

Indonesia in the next 25 years will increase rapidly. The age structure of Indonesia

population is still young and about 30 percent of the total population is below 15 years.

Although compared to the developed countries, the percentage of Indonesian elderly

population remains low, the number of elderly people, however, has grown rapidly. This

means that responding to the aging population will become a significant policy issue for

Indonesia.

8 The UN World Population Prospects, (the 2000 Revision), people aged 65 and above (old age) and
children below 15 years of age (young age) are considered to be dependent on the age group between 15-64
years. The ratio of the population between 0 and 14 years and the population aged 15-64 years is referred to
as the young-age dependency ratio. Similarly, the ratio of the population 65 years and above to the
population aged 15-64 years is called the old-age dependency ratio. The total dependency ratio combines
the young-age and old-age groups relative to the 15-64 age group. It is also referred to as the sodetal
dependency ratio.

9
2.4. Factors Related to Demographie Changes

Demographie change in Indonesia has been caused by the following factors: an

increase in the life expectancy for the population, lower fertility rates and a slower

population growth. Accordingly, the elderly population of Indonesia, Liberia, Thailand

and Colombia is expected to quadruple between 1990 and 2025. This will put heavy

pressure on the financing of social protection in the long run (Mas on & Lee, 2004).

However, if we try to understand this situation primarily as a consequence of the recent

dec1ine in fertility, the resulting picture is likely to be severely truncated, leaving out both

the major causes of structural ageing and the existing management of elderly welfare.

Pool (2004) remarks that structural ageing (the shi ft to higher proportions of the

population at older ages) is only the final phase of a wider and more complex process of

age structural transition. The Indonesian case contains a number of surprises which

makes it a particularly rich field in which to consider age-structural dynamics.

Infecundity, divorce, and political stability, together with the continuing importance of

migration, are cri tic al to understanding currently high proportions of elderly people.

2.5. Aging in lndonesia

Over the last ten years, few researchers have studied aging in Indonesia. Research

on ageing has overwhelmingly focused on industrialized countries. Studies have focused

on caring, rural situations and need (Schroder-Butterfill, 2003). In addition, Kreager &

Schroder-Butterfill (2003) c1aim that although there is sizeable literature on

intergenerational transfer in developing countries, the Indonesian literature is as yet

small. Schroder-Butterfill (2003) investigated intergenerational relations and older

10
peoples' support networks in Indonesia and found that one third of older parents are net

providers for intergenerational material support, and almost half of these are assisting

their adult children or grandchildren. Breman & Wiradi (2002) highlighted the economic

problems of the elderly populations in the rural areas of Subang and Cirebon9 Breman &

Wiradi (2002) called this population "the under-class of ultra-po or" because of their

tenuous situation. They stated that the ultra-poor have not only been denied access to the

labour market, they are also unable to fulfill their own basic needs. Eeuwijk (2003) has

studied growing old in the city of North Sulawesi, Indonesia and described the medical,

physical, financial, and social vulnerability of the elderly.

From these selected review of studies on aging in Indonesia, it is evident that

there is a lack of information about how Indonesian society and the state see and respond

to older people. These studies were unable to answer questions about the major problems

faced by the elderly and the social programs meant to address their needs. For example,

how does the state respond to the rights of its elderly citizens? What kind of social

services should be available in our society? How do culture, religion, and gender shape

aging issues in Indonesian society? And what are the implications for social work

practice in Indonesia?

3. Research Topicl Research Aim

This study aims to describe the issues, laws, and services for older persons in

Indonesia and examines the influence of culture, gender, and religion in shaping

understanding aging issues in Indonesia. As weIl, and most significantly, this study

9 Both are located in the West of Java, Indonesia.

11
examines the implications of aging issues in Indonesia for social work practice -

particularly as they relate to cross-cultural issues in aging.

Specifically, this study:

1. Aims to understand the issues or needs of eIder people in Indonesia.

2. Aims to understand the laws in respect to older people in Indonesia and the

way this may shape services (e.g. VU No 13/1998 about EIder Welfare).

3. Aims to understand the kinds of professional and community services (e.g.

state, NGOs, and religion-based) currently being offered as well as needs for

future services (e.g. home for the aged or Panti Tresna Werdha).

4. Aims to fill the gap in social intervention and social services in Indonesia. It

will also address the gap in knowledge and policy analysis in Indonesia.

5. Aims to understand the implications for social work in Indonesia.

4. Research questions
This study will seek to answer the following questions:

1. What are the major problems faced by the elderly in Indonesia?

2. What are social policies or laws gui ding the services for the elderly

people in Indonesia?

3. How does context (culture, gender, and religion) shape agmg m

Indonesia?

4. What are the implications for social work in Indonesia?

12
 CHAPTERII
METHODOLOGY

1. Overview
This study draws upon qualitative methodologies in order to address the stated

questions. Qualitative research methods are designed to examine the meanings of events

and social participation in natural settings (Hendricks, 1996). Qualitative research is

characterized by its emphasis on describing, understanding, and explaining complex

phenomena and thus such an approach is appropriate for developing a full, multi-

dimensional, dynamic picture of aging in Indonesia.

Newman & Kreuger (2003) claim that social work research aims to critique and to

transform social relations. More specifically, they suggest that social work research

should uncover myths, reveal hidden truths, and help people to change the world for

themselves. As a social work practitioner/leamer, 1 intend to examine the aging issues in

Indonesia according to these research guidelines.

Within the scope of social work research methods there are many theoretical

approaches and perspectives that can be used to gain data from participants. The feminist

perspective is one of these approaches. 1 drew on this approach by focusing on accessing

participants' reflections and opinions about the gender issues which shape how older

people are viewed in Indonesia. Newman & Kreuger (2003) claim that the feminist

approach attempts to give a voice to women and to correct the male-oriented perspective

that has been predominant in the development of social science. According to Acker

(1998), in aH known societies the relations of distribution and production are influenced

by gender and thus take on a gendered meaning. Feminist approaches may include a

13
variety of methods inc1uding interviews and case studies. However, they are united by the

focus on gendered experiences.

As l have mentioned earlier, there are few studies or research on aging found in

Indonesia, compared to other social topics, such as street children, or women trafficking.

As a result, there is little prior research to draw on in order to understand how aging is

conceptualized in Indonesia. My study is thus a preliminary contribution to this field. l

conducted exploratory qualitative interviews and observations in order to get data,

information, and reflection from people about this topic. l was interested in looking at the

feelings, experience, knowledge, and expectations about the social issue of aging in

Indonesia 10. Furthermore, l used a qualitative approach because l acknowledge the

importance of examining social contexts in order to understand the social world

(Newman & Kreuger, 2003). Here, my role as a researcher was as an active learner who

can tell the story from participants' viewpoint (Mastronardi, 2005). Similarly, reflexivity

was a significant feature of this research. For instance, l accepted that my biography, my

own values and beliefs, and my personal conduct would be intrinsically bound up with

the progress of the field work gathering and analysis of the data.

2. Data Collection Methods

To understand and describe aging 111 Indonesia l used the three methods of

qualitative data collection: observation, interviews, and documents analysis.

10 Mastronardi (2005) "Qualitative method is about relationship between people, place, and work as weil as
about experience, meaning, perception, stories, life, relationship, and understanding" (class notes, January
04).

14
2.1. Participant Observation

The tirst method l used to gather information was participant observation.

Grinnell & Unrau (2005), postulate that observation is a process by which a measuring

instruction is used to calibrate certain predetined properties of an observable variable. In

participant observation the researcher draws on their own perceptions and observations.

"It involves the observer's becoming a part of -and a participant in -the groups
and communities being observed so that the role taken with those observed is less
distant and more "inside". It includes the same basic processes of seeing,
recording, and coding and analyzing what is seen, although adapted to the role the
observer takes in research setting" (Grinnell & Unrau, 2005, p. 228).

Hammersley & Atkinson, (1995) indicate that social research involves

participating in the social world, in whatever role, and reflecting on the products of that

participation. My identity as an Indonesian women helped me to gain an insider's view of

community life in Indonesia.

l observed three different sites: the Division for Elderly Welfare within the

Department of Social Affairs of the Republic of Indonesia, the home for the aged (panti

tresna werdha), and general observation in daily interaction in Indonesia. To gain access

to these sites, l contacted the director of the eIder welfare division and introduced myself

as a graduate student at School of Social Work, McGill University. l explained the

purpose of my study and was granted permission to visit the department's homes for the

aged in order to observe its daily workings.

The tirst agency l visited was the Social Affair of Republic Indonesia. Here l met

with its workers in the division of elderly welfare (on July 18, 2004 and August 09,

2004). This is astate based institution that is mandated to manage and to deliver the

social service for the vulnerable people ("Penyandang Masalah Kesejahteraan Sosial

15
(PMKS)") , or those who are at risk of poverty and disability, such as the street children,

disable, elderly neglect, and the like. The Division of Elderly Welfare is the

representative division in this department that is charged with supervising govemment

programs and social services for the elderly. As well, this division is the center of the

process where aging issues are examined at a policy level. To enrich my observation, I

talked with the director of the elderly welfare division as well as with the staff worker in

this division asking for general information conceming their programs, services, and

planning for the oIder people in Indonesia. Similarly, I asked to their pamphlets,

guidelines, modules, and brochures in order to see their efforts in providing the services

for older persons in Indonesia.

The second agency I visited was a social services home for the aged or "panti

tresna werdha" in Jakarta in order to observe the daily services provided by the

institution and the daily life of the dwellers. I talked with the workers of the panti to get

information on their role in the panti and I observed the dwellers' needs and problems in

two periodical visits (one hour for each visit). The purpose of the first visit was to get a

global view of the agency, whereas the second visit was to follow up and get more details

about what was observed in the first visit. In order to record my observations, I took

detailed field notes. I also gathered each agency's pamphlets, guidelines, modules, and

brochures. These documents helped me to understand the vision and mission of each

agency as weIl as the programs that they deliver for the elderly people in Indonesia.

The third setting of my observation was general observation in daily interaction

with people and it's surrounding during the visit to Indonesia for two months. Although

not an official site, I observed older people in buses, public facilities, and the like. The

16
lenses of course must be different after one year visit to Indonesia. My way of seeing

things was likely quite different after having lived outside of Indonesia for the period of

one year.

Figure 1: Observation Sites

Site Mandate
Site One Elderly Welfare Department of the - astate based institution
Social Affair of Republic Indonesia - Implements social
policies related to the
elderly in Indonesia.
- Provides informational
and tinancial resources to
community organizations
that work with the elder!y.
SiteTwo The Home for the Aged (panti tresna - provides residential care
werdha) for the neglected elderly
people in Indonesia.

Site Three General Observations - a societal relationship

during the visit to
Indonesia

2.2. Semi-structured interviews

The second method 1 used for gathering data was the in depth interview. Grinnell

& Unrau (2005) daim that interviewing is at the core of social work practice and it is the

most consistently and frequently employed in social work techniques. The advantages of

interviews as a data collection method are related primarily to naturalness and

spontaneity, flexibility, and control of the environment. Thus, this method helped me to

gain information from the participants because they felt more at ease responding to my

questions orally than they would have felt if they were asked to write their responses. As

weB, the casual and relaxed context of the interviews provided room for encouraging

spontaneous answers and unexpected responses. The flexibility of this method aBowed

me to rephrase questions that participants did not understand. Conducting the interviews

17
in the participants' environments meant that 1 could directly listen to their original views

and feelings without their being influenced by other people.

My interview sample consisted of ten participants (five males and five females).

The participants in the study were either paid workers or volunteers in social institutions,

social services, or community organizations and caregivers. Each interview was

conducted for fifteen to sixtY minutes. 1 took notes and recorded the interviews.

The interviews focused on three main areas: issues, laws, and services for older

people in Jakarta in particular and Indonesia in general. 1 utilized a semi-structured

interview format, drawing on an interview guide (see appendix for the interview guide).

The interview guide included a mix of open-ended and more structured question in order

to confirm the interpretive validity of the findings, the participants were shown a

summary ofthe interview and they were asked to comment on its accuracy.

1 selected the participants using three different methods. The first method

involved using the internet to search for authorities in the field of social gerontology in

Indonesia. 1 looked for individuals who had pub li shed academic journal articles on this

topic and then 1 contacted them to invite them to be interviewed for this study. Secondly,

1 contacted the director of the Elderly Department in the Social Affair of Indonesia and

asked him to refer me to a participant who works in his office. FinaUy, 1 sent letters of

introduction and a short description of the proposaI to the government offices mentioned

earlier and to the participants from "panti jompo" and NGOs. 1 sent this information by

mail and email to directive agency workers, asking them to invite workers with expertise

in aging to consider participating in my study. 1 asked them to forward information to aU

18
workers and 1 told them that 1 would contact worker by email (or by telephone III

Indonesia) to provide information about the study.

Figure 2: Interview Participants

Numbers Settin~
1 W orker from Social Affair
2 NGO Workers / Activist
1 Workers from the Home for the Aged (Panti Tresna Werdha)
2 Community W orkers
3 Caregivers
1 W orker from Religious Institution

2.3. Document Analysis

The third method of data collection incorporated the analysis of documentation

related to aging in Indonesia. Written documents about social services and social policy

for elderly people in Indonesia were gathered during visits to Jakarta (between June 18,

2004 - August 17, 2004). These documents included organizations' pamphlets,

newspaper articles, books and journal articles about the elderly. 1 looked at published

government policy documents; including the Act of elderly welfare to understand how

these social policies were implemented at the practicallevel.

1 conducted this research while living in Canada (with the exception of one

summer stay in Indonesia). In addition, the documents analysis was also based on the

published articles and books on aging and social issues in Indonesia gathered since the

June 2004 to June 2005. This information enriched my data collection in order to

understand and to describe the aging issues in my country as 1 was not in Indonesia

during finishing this study.

19
 Figure 3: Policy and Practice Documents

No. Level Includes

1. Social policies documents - The elderly welfare Act: VU No. 13/1998
- The state or national planning of social
policy for older people in Indonesia
- Published articles, joumals, and books
articles conceming on social policies for
older persons in Indonesia

2. Practices documents - The social services that implements the law

of elderly welfare
- Includes pamphlets, guidelines, agencies
profiles, brochures, etc. about the social
services provided for the older people in
Indonesia
- Publsihed news or "up dated" information
on older people activities in Indonesia

3. General documents - Includes aIl publisehd documents on aging

issues which is relevant to the study of
aging in Indonesia

3. Data Analysis
1 used a traditional "cut-and paste" form of data analysis for this study (Grinnell

& Unrau, 2005). 1 classified those having the same meaning (e.g. topics repeated) into

units or categories of the participants' responses as weIl as the written documents

available. After engaging in this process using the written transcripts and written

documents, a number of commonalities and sorne differences emerged. The data analysis

of this study draws on the grounded theory. Glaser & Strauss (1967) who developed the

grounded theory methods state that the aim is to discover the theory implicit in the data.

The analysis process of this study ai ms at constructing theory in order to understand

aging issues in lndonesia (phenomena)ll. 1 consciously combined the data collection and

data analysis as weIl as the initial data analysis in order to shape continuing data

Il The grounded theory approach as a qualitative research method that uses a systematic set of procedures
to develop an inductively derived grounded theory about phenomenon (Sraws & Corbin, 1990, cited in
Newman and Kreager, 2003: 158).

20
collection. In short, data collection, note-taking, coding and memomg occur

simultaneously from the beginning. This procedure helps me to gain more opportunities

to increase the "density" and "saturation" of recurring categories.

From there, 1 examined each category and put them into separate themes.

Furthermore, 1 identified any relationships between the major themes (this will be

discussed in more detail in the following chapters).

4. Ethical Issues
No older people were directly involved in this study. In cases where older pers ons

names appeared on documents or in interviews these names have been replaced with

pseudonyms. The names of all participants are confidential. Using pseudonyms for the

participants and maintaining confidentiality in the fieldwork and interview process helped

to ensure subject confidentiality.

It was important to build trust between me and my participant. 1 therefore emailed

my consent form to each participant to inform them of the purpose of my study and to

assure them that 1 will keep their responses confidential. Although sorne of my

participants appeared to be unaware of the purpose of consent forms, 1 felt it was my

obligation to prote ct myself and my participants from any potential harm. This lack of

awareness about the research consent form might be due to the fact that in our culture (a

communal society), the issue of confidentiality is not considered as an important thing,

unlike in the West.

Although workers were speaking in the capacity of their jobs, and therefore

considered a group at minimal risk, there was a slight possibility that participants from

govemment offices could have felt reluctant to participate for fear that it might jeopardize

21
their employment. As well, participants from the ''panti'' and NGOs may have been

concemed that participating in this study might jeopardize govemment supports-

especially if they were critic al of the govemment. 1 did not ask participants to comment

on personal experience. 1 also informed my participants that their participation was

entirely voluntary and that he or she may withdraw their participation at any time. 1 also

requested participants' permission before tape recording or taking notes on the

interviews. Finally, 1 asked participants to review the summary of their responses and

asked them if there were any remarks that they would like to keep confidential or left out

of the report. In particular, 1 explained that their responses to the questions on

govemment's policy will be completely confidential, meaning that their individual

responses for these questions would not be identified with their name or positions.

One important ethical issue that was raised in the research process concemed the

language of my interview, because it is important to try to understand the language or

culture of the respondent. To do so, one must pay attention to added layers of meanings,

biases, and interpretation, which may lead to disastrous misunderstandings (Fontana &

Frey, 2000). Although 1 do not have difficulties in using my participant's language (since

my participants were Indonesian), 1 used the language of "bahasa I2" Indonesia during the

interview. However, for the purpose of this report, 1 need to translate the participants'

responses into the English language. 1 wondered how the potential for misinterpretation

or mistranslation will influence my ability to transfer meaning into the English language

(which it is my second language).

12 The word "bahasa" refers to the Indonesian language or bahasa Indonesia, which is often use by people
and foreigner in order to mention it simply and shortly instead ofusing the complete word ofbahasa
Indonesia.

22
 Another ethical issue that was raised in my study concerned personal, social, and

institutional influences or biases in analyzing my data. Whitmore (1998) illustrates how

research and analysis includes asking 'how did l identify myself in the research project?'

For example, my identity as a woman and a student who is studying in the Canadian

context means that l need to be aware of any potential gender biases that will occur

during my interviews with participants who still 'hold' the patriarchal culture. For

instance, when l asked one of the male participants about gender issues related to the

aging issues in my society, he seemed to tease me about my gender awareness that is a

result ofmy background studying in the Western society (which values gender equality).

There are sorne other important elements that l thought could lead to biases

during the interview. The ages of my participants' also become an issue in my study.

Particularly, this may due to the nature of our paternalistic culture. Grinnell & Unrau

(2005) postulate that indeed the considerable disparity in age between interviewers and

interviewees may contribute to the biases of either. For instance, most of my participants

were social workers in Indonesia, who hold "Eastern" values, including those of respect,

listening, and avoiding interrupting. So, during the interview, when l tried to probe or ask

direct question, sorne participants seemed to not respond positively, showing me that he

or she has more knowledge and experience. Although l am Indonesian, the format of a

Western interview reveals the challenges of conducting cross-cultural interviews. It is

important that techniques be relevant to the culture. In my interview l tried to bridge this

gap following the 'tradition' while at the same time, l tried to introduce the new way of

'equal-based' conversation during the interview.

23
 CHAPTERIII
MAJOR SOCIAL PROBLEMS, SOCIAL POLICIES AND SERVICES
FOR OLDER PEOPLE IN INDONESIA

This chapter address two major problems of older people in Indonesia identified

in this study, and the social policies and services meant to address them. A number ofkey

themes emerged from the interview and documents. Combining the data with existing

literature, this chapter will specifically comment on two major issues of social security

and poverty, and review the main policy (Act No. 13/1998) and services intended to

address them.

1. Social Security and Poverty

1.1. Social Security for the Elderly
Both the participants in this study and the document analysis suggest that a major

problem faced by older people in Indonesia concems social security (jaminan social).

This means the lack of formaI support and non formaI support available for elderly

people in Indonesia such as the comprehensive pension system and free health care for aIl

citizens. Take the example the words of Arie, who c1aims that aging is a complex issue in

Indonesia. He suggests that defining the major problems of the elderly population is not

an easy task. This may be related to the global problems faced by Indonesian citizens in

general. These problems inc1ude poverty, health access, unemployment, and the like. Arie

daims, however, that the major problem faced by the elderly people in Indonesia is the

"absence" of social security:

24
 " .. .1 agree that Indonesia has a very little attention to the issue of elderly
people. However, according to me, the major social problem of the elderly
people in Indonesia is the absence of social security. In fact, the elderly
issue is a serious problem especially for those who do not have anything,
without any family support system" (Arie, NGO activist).

Although Arie claims that there is an absence of a social security system in

Indonesia, 1 found the govemment and informaI compames have made an effort to

implement a "complete" social security scheme. The former President Megawati

established "the Presidential Task Force on Social Security Reform" chaired by Prof.

Yaumil Achir. This task force concluded that social protection systems consist of three

layers of protection: (1) A Social Safety Net, providing basic protection such as primary

health care and subsistence level income security (which would ordinarily be provided by

the State, financed from taxes); (2) Social Insurance Schemes, financed by contributions

from employers and workers -providing income maintenance benefits during periods of

health care with sorne retribution of income within and between generations; and (3)

Supplementary (voluntary) private provision by individuals, employers or occupational

schemes for pension savings and health insurance. These proposaIs however, are only

slowly being integrated.

However, Setiabudhi (2003) argues that Indonesia does not have a proper social

security scheme yet and this willlead to a very difficult situation if the ageing population

continuous to increase. The CUITent social security scheme only reaches certain members

of the population. This system benefits people in formaI sector and employers in big

companies and is not for those who work in non-formaI sector or work in small scale of

labor work.

25
 According to Suharto (2003b), a social policy analyst, a social security system or

''jaminan sociaf' can be defined as the financial aid system or the social services put in

place to prote ct individuals from the risk of financial loss and financial inability caused

by accident, disability, unemployment, aged, and death.

"The term social security is mainly now related to financial assistance, but the
general sense of the term is much wider, and it is still used in many countries to
refer to provisions for health care as weIl as income. Although the benefits of
security are not themselves material, they do have monetary value; people in
Britain, where there is a National Health Service, are receiving support which
people in the US have to pay for through private insurance or a Health
Maintenance Organization (Suharto, 2003b)."

James, E., (2003) claims that lndonesia has a traditional social security scheme

where pensions are based on workers' wage and years of contributions. This "pay-as-

you-go" system (PAYG) has sorne limitations. It is a scheme that is only offered to those

in the civil service and not to those in the private sector. As weIl, the funds workers

accumulate are invested by a public agency (called "Jamsostek" or Jaminan Social

Tenaga Kerja)13, and so there is a potential risk ofpolitical control and low return.

JAMSOSTEK was launched during the New Order Era (1966). According to Act

No. 3/1992, JAMSOSTEK coverage includes: Work accidents, Old Age Support, Health

Care and Death. Until now, this Social Security Scheme has been generally only

available to people in formaI employment and to people who are obliged or entitled to

participate in a variety of social insurance schemes. Keasberry (2002) suggests that social

security programs are typically limited to government-employed individuals with sorne

13 A Worker's Social Security Program (Jamsostek). Employers are responsible for the entire contribution
for occupational accident security, and death security programs. There are five classifications by industry
with contributions for accident of the employer. The contribution for death security is 0.3 % of one's wage
(http://www.asiatradehub.com/indonesialtax.asp).

26
complementary special welfare programs available to the impoverished and the impaired.

Social security provisions cUITently extend to the employees of the military, employees of

civil service, the population employed in smaller enterprises; those who are self-

employed or aged; and to those who rely on private insurance or support from immediate

and extended family and the local community. Setiabudhi (2003) notes that it is most

likely that the extension of social security entitlements to entire population will be a long-

term goal.

The pension system which may be considered one aspect of social security is also

relevant to understand the social needs of elderly people in Indonesia. Wachmatarwata

(2004) daims that the CUITent pension system in Indonesia undoubtedly needs evaluation

and improvement. InformaI workers, for instance, do not have any income protection

when they reach old age.

"CuITent pension system in Indonesia undoubtedly needs evaluation and

improvement. Uneven legislations produce unequal treatment among various
types of workers. Sorne groups of workers may enjoy lump sum benefits at
retirement and monthly pensions afterwards, while the others have to be
comfortable receiving small amount lump sum benefits. Informai workers, in the
worst case, do not even have any income protection at old age (Wachmatarwata,
Isa., a Directorate of Pension Funds, Ministry of Finance, Indonesia, 2004)."

In their study of age structural dynamics and local models of population ageing in

Indonesia, Kreager & Butterfill (2003) illustrate that another common problem of aging

in Indonesia is that assets in the form of labour or pensions will not guarantee a secure

old age if most of that income is used to share up the position of other family members.

For instance, I observed a pensioner couple (Juned and his wife), who share their income

pension to "feed" their unemployed family members. So, in this case pension benefits

would no longer be used to just support their own life but also to support the survival of

27
other family members. As a result, this couple has difficulties managing their income for

their own needs such as health, and lei sure activities. Nevertheless, pensions may be

important as a mechanism of economic redistribution amongst poorer families (Kreager

& Butterfill, 2003).

Meanwhile, as Marianti and Van Eujwijk (in Kreager & Philip, 2003) suggest,

govemment policy regarding health and welfare provision remains inadequate. Pensions,

for instance, reach scarcely more than 10 per cent of the workforce. Recent plans by the

lndonesian govemment to introduce a 'universal' social insurance system in fact only aim

at the minority of formaI sector workers. The most vulnerable will continue to be

excluded. These problems particularly affect the elderly who live in rural areas and who

tend to work in the informaI sector, such as in agriculture. Dung Do-Le & Raharjo (2002)

postulate that the largest proportion of the po or elderly in lndonesia work in agriculture

or in the informaI sector, and belong to families with little or no savings. Lloyd-Sherlock

(1997), in his study of old age and urban poverty in the developing world, also points out

that the formaI security programmes in developing countries usually favour urban areas.

lndonesia, in my point of view, should want to leam from other countries to solve

these problems. For example, we can leam fromThailand, which has introduced a new

social security scheme covering about 2 million workers and their dependants. Old-age,

family, and unemployment programs are being phased in since 1998. The State Council

of the People's Republic of China examined the Reform of the Old-age Pension System

in June, 1991. They focused on the need to extend pension coverage to aIl workers, the

need to introduce pension contributions by these workers, and the need to establish the

legal basis for the operation of an old-age pension system. In a complementary move, the

28
Indonesian State Council authorized the Ministry of Civil Affairs to begin an

experimental rural social endowment insurance pro gram for people in rural areas.

Further, in January 1996, the State Council issued a circular expanding the program,

which currently includes the participation of 50 million farmers.

Suggestions to prepare for the retiring age at the personal level have also been

made. For example, in the recent article in the "Jakarta Post" (June 15, 2005) written by

Tjahjono suggests that it is important to plan for financial security for those 40 years old

and over. He created the term "pay your self first", which means that, as much as

possible, each pers on must save a "buck" of their money for their future retirement.

However, again this only covers those who have adequate income. It does not account for

those already excluded from labor and capital.

1.2. Poverty and the Elderly

The second major problem found in research is poverty of elderly people in

Indonesia. Although there are no official rates of poverty among the elderly, Dung Do-

Le, & Raharjo (2002), in their study of the community-based support for the elderly in

Indonesia, argue that since poverty remains significant in Indonesia, it can be assumed

that it is significant problem for the elderly. Similarly, according to Suharto, the total

number of the poor in Indonesian was 35.7 million in 2002 and 15.6 million (43 percent)

were the poorest of the poor (2003a). Understandably, the economic crisis which began

in 1997 has a caused considerable decrease in the general standard of living. The share of

the population living under the poverty line has increased sharply from Il per cent in

1997 to 21 per cent in 1999 (Setiabudhi, 2003).

29
 Indeed, 1 feel that aside from those who are unemployed, women, and children,

the elderly are ranked the most vulnerable to poverty in Indonesia. This is due to the

impact of globalization, urbanization, and "capitalism". For instance, the "job market"

demands that those who are employed be at a productive age. In Indonesia, even those

people who are considered to be at productive age are still becoming unemployed.

Employment of older pers ons therefore, whom are considered 'unproductive' is unlikely.

1 believe that the aging population will be especially vulnerable to these changes, because

they are stereotyped as unproductive and dependent on family members.

The problem of poverty is a specific problem for those in rural areas. Breman

& Wiradi (2002) highlighted the economic problems of the elderly populations in the rural

areas. They called vulnerable elderly people "the under-c/ass of ultra-poor" because of

their tenuous situation. They stated that the ultra-po or have not only been denied access

to the labour market, they are also unable to fulfill their own basic needs. They use the

example of an elderly couple in the Cirebon area that has not eaten for three days as an

example of the situation of elderly people in rural areas (Breman & Wiradi, 2002).

The existing social security scheme and pension system in Indonesia also raises a

critical issue in relation to poverty. As we know, the CUITent system primarily benefits

civil servants. This means that many have no security. Suharto (2003a) argues the

Indonesian social programs are failed to address to combat the impact of poverty in

society such as neglect and ineligible homes or "ketidaklayakan hunian".

According to many of my interviewees, elderly people need subsidies from the

govemment to support their life. Arie claims that subsidies could be helpful for older

people to get a social "guarantee" oflate life security.

30
 "In my opinion, the need of elderly people is subsidies from the govemment of
Indonesia in order to protect and to "guarantee" their life safety. Because, 1 find
there are many elderly people who are not able to meet their daily needs, while
they are very poor." (Arie, NGO activist).

ln addition, according to Rudi, subsidies should become astate responsibility and

the elderly should have a right to the support needed to maintain their life during

retirement.

"1 think there are many things can be done by the govemment in order to prote ct
the life of the vulnerable people. Beside they should build social awareness
towards the need of the elderly, but the most important is that they should provide
subsidies for the social program targeted for the elderly people. These are the
govemment responsibilities and are on elderly right 1 think" (Rudi, Community
worker, 2005).

Neglect is also an issue that affects older people in Indonesia. According to

Suharto (2003a), the percentage ofneglected elderly people has reached 55.64 per cent of

the Indonesian population. This calculation includes both those who have suffered elder

neglect and those who are at risk of suffering neglect. According to Central Bureau of

Statistics (Badan Pusat Statistik), the percentage of the elderly who suffered from

neglect l4 was 3 485 066 people in 2000. The Age WeIl Organisation in New Zealand

(2005) defines eIder neglect as a pers on aged 65 or more who experiences harmful

physical, psychological, sexual, material/financial or social effects caused by the

behavior of another person with whom they have a relationship implying trust. Neglect in

bahasa means "terlantar" and refers to situations where a person suffers from poor

nutrition, poor health, inadequate care due to a lack of attention from the family,

community, and state. It is estimated that the percentage of neglected elderly will reach

14 While the general dictionary de fines neglect as, "to pay little or no attention to, disregard, etc".
(http://www.thefreedictionary.com/neglect).

31
about 8.5 per cent (19 million) in 2005. Suggestions such as those made by Rudi will help

the poorest of the poor address existing and potential neglect.

2. Indonesian Social Policies for Older Persons

My review of key policy documents revealed two main policies related to the

elderly in Indonesia (the Act No. 13/1998 and the National Commission on Elderly

Welfare), and a number of social services that implement these policies. Nevertheless,

interviews with my participants suggest that knowledge about these policies is uneven.

This is may be due to the lack of socialization from the govemment about the policies, as

weIl as a lack of awareness and willingness from society to know about the policies.

2.1. The Elderly Welfare Act (UU ND. 13/1998)

Indonesia is not a "welfare state" 15, however the govemment is working to

establish a social policy targeted to its vulnerable and dependent citizens such as children,

the elderly, and the unemployed. Since its independence day in 1945, the govemment has

launched several social initiatives to support vulnerable people, including the elderly.

They are: Act 4/1965 which stipulates the state responsibility to provide aid to the elderly

population and Act No. 13/1998, which concems the welfare of the elderly in Indonesia.

Act No. 13/1998 consists of Il sections and 32 articles. Section one (1) discusses

the overall definitions of elderly-related issues, such as welfare, elderly, family,

community, social security, social assistance, empowerment, and the like. Section two (2)

15 The idea of the "welfare state" means different things in different countries. An ideal model refers to an

ideal model provision, where the state accepts responsibility for the provision of the comprehensive and
universal welfare for its citizens; state welfare refers to "welfare provided by the state"; Social protection
refers to that in many "welfare state", social protection is not delivered by the state at aIl, but by a
combination of independent, voluntary and govemment services. These countries are still usually thought
of as "welfare states" (Spicker, P., 2005, http://www2.rgll.ac.lIk/pliblicpolicy/introdliction/wstate.htm).

32
describes the philosophy, guidelines, and objectives of this law which was created to

strengthen the elderly population. Section three (3) concerns the rights and

responsibilities of the elderly people in the society. Section four (4) describes the state

responsibility towards the elderlY population. Section five (5) describes the need for

empowerment and social services to strengthen elderly welfare in Indonesia. Section six

(6) governs the implementation of each social service program. Section seven (7) outlines

the role of the community in caring of the elderly population. Section eight (8) governs

the coordination of each of the social institution. Section nine (9) reviews the

administrative factors. Section ten (10) acknowledges that this law has similar objective

to the previous law (Act 4/1965) concerning assistance and aid for the vulnerable eiderly.

The last section (11) includes a closing remark, acknowledging that this law replaces the

previous law (Act 4/1965)16. In section four, article seven, it states that the government

has a responsibility to strengthen, to assist, and to create better environment in order to

strengthen the welfare of older people. At the same time, older people hold similar rights

due to their citizenship in Indonesia.

The Division of ElderlY Welfare (of the Department of Social Affair of Republic

Indonesia) has promoted and coordinated with companies and social institutions to

conduct a number of initiatives. The 'everlasting' Residential Card or kartu tanda

penduduk (KTP) for citizens who are at least 60 years old provides the advantage of not

requiring renewal every five years. The public transportation now provides a reduced

price or discount for the elderly 17. As well, the elderly have the right to affordable health

16 Signed in Jakarta on the 30th ofNovember 1998 by the President of Republic Indonesia, Baharuddin
Joesoef Habibie, and the Ministry of State Secretary of Republic Indonesia, Akbar Tanjung.
17 For instance, the Garuda Indonesia (Indonesian National Airplane) since 1996 provided a discount (30

per cent off) for tickets for the elderly.

33
care, meaning that if an elderly person is hospitalized or is unable to afford health care,

they have the right to a discount. This is due to the high expense of health and hospital in

lndonesia and the fact that not aIl citizens have health insurance.

Sorne NGOs and not-for-profit organizations are initiating services for elderly

people. PKBI (Perkumpulan Keluarga Berencana Indonesia), for instance, has struggled

to educate the public about the need for social recognition of elderly people in lndonesian

society. Particularly this institution is focusing on the health issues of older people.

However, compared with other developing countries in Asia, lndonesia has far to go in

initiating social programs for its elderly people.

According to Suharto (2003a), poverty and the social "gap" are the two central

issues dominating the formulation and the development of social policy discourse in

lndonesia. Furthermore, there are many factors that impede the development of an

lndonesian welfare state, such as the lack of visionary willingness and action, and the

need for a best mechanism system of social security. Sorne argue that an Indonesian

welfare state could be implemented based on the idea of "welfare pluralism H. This refers

to the move from state welfare to welfare partnership, and means that to address these

obstacles; there is a need for cooperation from aIl parties and stakeholders, including the

state, and the community as weIl as the local indigenous groups to help the vulnerable

people. For instance, drawing on the idea of welfare pluralism, the lndonesian State

Council could "integrate" the welfare system (which is mostly influenced by "Western"

approaches) with the religious-based informaI social welfare efforts, in order to establish

a more pluralistic social welfare system.

34
 The absence of social policies is a major issue in Indonesia as weIl. Arie, a

participant in this study, argues that the 'absence' of social policies for elderly people is

due to our culture, which values the family role in caring for their elderly people. He also

argues that this issue does not take 'priority' in our society. Instead, poverty,

unemployment, street children, and education are the state's and community's priorities.

As a result, elderly welfare is not considered a social concem. Instead, it is seen as a

'domestic issue'. Arie provided an illustration of the way that the govemment and

community frame social problems as private: When the govemment launched the Act for

Conjugal Violence or KDRT (Kekerasan dalam Rumah Tangga), both the state and the

community engaged in a great debate about this issue. They argued that it belongs to the

'private' or 'domestic' sphere and the state should not intervene in its people's personal

business.

"1 see that the elderly people so far have not become our community and states'
priorities yet. May be 1 would say that the elderly issue is ranked on the eight or
tenth of our govemment agenda. Let's take a look at what happen recently when
the house of representative discussed about the KDRT laws to end aIl kind of
conjugal violence in society. But what is happening is that, they are arguing that it
is the private issue, and therefore the govemment or public should not involve in
and intervene in its citizen private problems (Arie, NGO activist)".

2.2. National Commission for Older People (Komisi Nasional Lansia)

The formulation of the "National Commission for the Protection of the Elderly"

(Komisi Nasional Lansia) was a mandate of Act No. 13/1998 and later broke down into

the "govemment regulation" or "Peraturan Pemerintah (PP)" and the "presidential

decision" or "keputusan presiden (Keppres)". According to the Ministry of Social

Affairs, Bachtiar Chamsyah, this commission has the potential to help the govemment

familiarize people with welfare, protection, advocacy, communications, and information

35
and education programs. This commission consists of inter-sector employees from the

government, non-government organizations, and the community. According to the

ministry, with this change, those neglecting older people will now be charged by the law.

Accordingly, the "emergency" agenda of this commission is to support and to encourage

the government through the house of representative to reform the social security scheme

in Indonesia. Moreover, to foHow up on this strategy, the government is presently

formulating the National Commission for Protection for OIder People (Komnas

Perlindungan Penduduk Lanjut Usia).

In addition, in 1996 Indonesia has declared "National Elderly Day" on the 29th of

May. This day is seen as a national commitment, in which each year aH parties of society

recognize and think about the elderly people in society. This day originated in response to

the Indonesian government's commitment to the United Nation Resolution No. 045/206

year 1991 concerning the international effort to pay attention to oIder people. This was

also a direct respond to the Vienna Plan of Action on Aging 1982 which was created to

invite aH nations in the world to establish the national elderly day l8.

3. Type of Services for Older People in Indonesia

3.1. State-based services

18 1t was known as "Hari Lanjut Usia" (HALUN) or the elderly day validated by the former President of
Republic Indonesia, Suharto, in Pucang Gading Semarang. The 29 of May was dedicated to Dr. KRT
Radjiman Wediodiningrat who was head or coordinated the first meeting of the "Badan Penyelidik Usaha
Persiapan Kemerdekaan Indonesia (BPUPKl)" or the legislation of preparation for the Indonesian freedom
in 29 th of May 1945 which was full with nationalism spirit through his wisdom and knowledge (Sumartono,
Social Worker at BKKKS, Suara Merdeka, May 28, 2005).

36
 This section describes the variety of social services available for the elderly

people in Indonesia, with a particular focus on those coordinated by the Department of

Social Affair of Republic Indonesia.

The Department of Social Affairs (Departemen Sosial) is an authoritative state

institution that is mandated to implement social services in Indonesia. Policies under this

institution are designed to strengthen social equality, to improve professionalism in social

services and community participation in delivering social services, to strengthen social

service management, and to support the implementation of the decentralization policy in

the national development process l9

According to the Ministry of Social Affairs, Act No. 13 1998 is becoming the

"work protocol" for designing social services for the elderly population in Indonesia. The

services under this act will be based on the Indonesian socio-cultural philosophy of "The

three generation in one roof", which means that there is a connection or interrelation

among three generations in the family (i.e. children, parent, and grandparent) regarding

the responsibility for its members. On practical level, the "direktorat pelayanan social

lanjut usia" or the Division of Elderly People, is made up of four programs or social

services for the elderly. The first pro gram focuses on the inside of the home for the aged-

based (panti tresna werdha) services. Through this program, the state "places" the

neglected elderly into a home for the aged. In this type of setting, the elderly are

guaranteed to receive their basic needs such as meat, clothes, health, lei sure activities,

social assistance, and spiritual assistance, sports, and skills training.

19 This policy is the translation of the Indonesian version of the Department of Social Affair (Kebijakan:
meningkatkan jangkauan dan pemerataan social; meningkatkan professionalisme pelayanan social serta
peran aktif social masyarakat dalam pelayanan social; memantapkan manajement social; dan mendukung
terlaksananya kebijakan desentralisasi dalam penyelenggaraan pemerintahan umum dan pembangunan).

37
 The second pro gram focuses on services provided for the elderly who are cared

for by family, community and social organizations. These types of services include home

care, and the daily provision of food for the "disabled" elderly people who live with

family members. This program is called PUSAKA (Pusat Santunan dalam Keluarga) or

family-based service. Foster Care is a social service for those who are neglected by

family members who had been willing to care for them under the social department

supervision. The "Bantuan Paket Usaha Ekonomis Produktif (UEP)" provides financial

aid for elderly people who want to work and need capital.

The third pro gram offered by the Division of the Elderly People provides

institutional-based services. This program is designed to provide both formaI and non-

formaI social services to meet the needs of elderly people (at the district level,

community level, borough level, provincial level, and national level). Furthermore, this

program also aims to facilitate the development of elderly institutions as weIl as to

strengthen existing elderly institutions. The services inc1ude strengthening human

resource professionalism as weIl as supporting the establishment of public facilities based

on the needs of elderly people. Another goal of this pro gram is to facilitate the creation of

a "network" among both national and international elderly-based institutions.

The fourth pro gram under this act provides social protection and accessibility

services for the elderly. Social protection involves the state and community taking

responsibility for fulfilling the needs of the elderly to improve their quality of life. The

social security services inc1ude the "Jaminan Kesejahteraan Gotong Royong (JKS-GR 20)"

or the Gotong Royong social security system, which is similar to the KUBE program

20 Ibid. p.8

38
(described earlier). The second form of social security provided by the Ministry of Social
1
Affair is the "Asuransi Kesejahteraan Sosial (Askesosl " or social welfare insurance.

3.2. Community and Religious-based Services

According to the Ministry of Social Affairs, community-based servIces or

"Pelayanan social Berbasis Masyarakat", should adhere to three requirements: the

community has a responsibility to provide the overall services for the elderly (neglected

and not neglected elderly); the community has a primary role in caring for the elderly

welfare; and social services for the elderly should be community- based. The objective of

this approach is to achieve a quality of life for elderly people. It should ensure that

elderly people are protected from social and psychological problems; that elderly people

are assisted in maintaining their social role in the community; that the elderly are

empowered to achieve independence and that the elderly enjoy self-esteem and self-

actualization in society.

There are five "formaI" religions followed by the Indonesian population. These

are Islam, Christianity (Protestant and Catholic), Buddhism, Hinduism, and Konghucu.

The World Facts Index (2005) reports that 88 per cent of the population adhere to Islam.

Kreager (2003) reports that the sheer size of the Muslim population leaves the scope for

religious influence at national and community levels preponderantly within Islam.

There is no definitive concept about the religious-based services in Indonesia, but

l have observed that there are many such social institutions and social services covering

the needs of older people in Indonesia. Each of these religious-based services has

attempted to facilitate and to accommodate older people. Mostly their services are

21 Ibid. p. 9

39
designed to help the vulnerable elderly people in their neighborhoods. Characteristically,

these services tend to originate in order to provide aid and daily assistance to older

people. This is a way of performing a religious-teaching that stipulates that helping

vulnerable people is an obligation and responsibility for the "able" and the "have" people

to help the "have not" people. These types of services vary among the institutions, from

health services, home care services to financial assistance to vulnerable elderly people.

ln Indonesia, the Islamic philanthropic 22 practice has been known since the

coming of Islam in Indonesia, which was supported by the social activism of religious

institutions such as "masjid" and ''pesantren'' (Bamualim, 2005). The PlRAC (Public

Interest Research and Advocacy Center) survey shows that religion has become the basic

pillar of charity practice 23 However, they used to be characteristically traditional in

nature, based on a charity model (helping the poorest of the poor). For instance, they

collect zakat from Moslems and distribute the money to help the poorest of the poor in

society. Along with this religious practice there are many Islamic philanthropic

institutions in Indonesia to manage and distribute Moslems' zakat.

One example of the Islamic philanthropy institution or can called religious-based

service available for the elderly is the "Layanan Kesehatan Cuma-Cuma (LKC)" of

Dompet Duafa Republika. This is a not-for- profit social institution that provides "free"

health services for the poorest people in the society. This institution helps the vulnerable

elderly people who need health service and does not require that they pay for the

medication. Darjo aged 73, who was sick and poor, for instance, benefits from this

22This refers to al! forms of the practical conceptualization of giving, service, and association for those
who need help on the spirit of Islamic religious-practice.

23 Republika Online, June 17,2005

40
service. According to a news report, he was found by the direct survey team of the LKC

to be living alone in a vulnerable situation with a serious illness. He commented:

"Thank God (Alhamdulillah), l am happy to be taken cared of the survey team of

the LKC and the help of doctors of this institution for my illness". "1 am looking
forward to return to work when l am better" (Republika Online, May 29, 2005).

3.4. Public-Based Services

The public-based services or the "popular based services" refer to those services

that are provided and initiated by public institutions or popular institutions. There are no

political and religious connections to these types of services. Instead, these services are

based on the ideal of humanity. These services are similar to the state-based services in

this way.

l observed one such service, called the "Lem baga Lansia lndonesia"in 2001. This

institution is part of the International Association Gerontology (IAG). Sri Mulyono

Herlambang (2001), a head director, explained the mission and vision of this institution.

Its vision is to achieve a comprehensive quality of life for the elderly people in Indonesia.

Its mission is to strengthen the quality of physical, psychological, social, and spiritual

health for the elderly; to enhance the knowledge and skills for the older people; to

increase the quality of social security; and to strengthen the law enforcement (jaminan

hukum) in Indonesia (Mulyono Herlambang, 2001).

Social security law (jaminan hukum) for the elderly, l believe should become a

serious agenda for us to design a social policy and social service. This law will help to

protect the elderly from neglect and violence from the society. For instance, according to

a news report, an elderly woman in Indonesia died after being hit by a car driven by a

41
policeman. The policemen did not want to be "responsible" for this accident and even

expressed his interest in not reporting this accident (Republika Online, May 25,2005).

3.5. Discussion
Need is the second criterion of social justice, and naturally its assessment requires

that relevant variables such as gender, age, and socio-economic condition be taken into

account (Azer & Afifi, 1992). A few studies have assessed the needs of the aged in

Indonesia. The major problems of older people described earlier became important or

emergency needs that the government should respond quite directly.

There are small numbers of social institutions and public facilities for the elderly.

However, as 1 described earlier, the social services available in Indonesia are biased

towards those who live in urban areas. For example, there is an absence of a local health

center (puskesmai 4 or posyandu25 ) for the elderly. As well, the homes for the aged are

mostly located in the city, so the village (rural) dwellers lack access to the panti jompo

(home care). This is very important to think about as there are many elderly people who

live in rural areas and who do not have enough money to go to the city and to pay for

medication. As well, there are many childless elderly people who live in rural areas. This

means that in the family system they may not receive the care they need. Moreover, in the

rural areas, there are neglected elderly people who would like to live in public areas and

who do not have a support system from family and relatives.

"Elderly women, especially in the rural areas, are usually very old, living mostly
al one, neglected due to ignorance, living po orly on subsistence economy and
chronically ill with multiple degenerative diseases. These frail elderly should be
the focus of social welfare assistance both by the public and private sector"
(Abikusno, 2002).

24 The abbreviation of Pusat Kesehatan Masyarakat (The Local Health Center)

25 Or Integrated health Post

42
 There have been sorne critical responses to the govemment's initiation of social

services for the elderly. Although it is important to note that these shortcomings are not

due to lack of willingness from the govemment or society to provide social care for the

elderly. There have been several initiatives with the potential to make change. Indonesia

has faced multiple crises since the monetary crises began in 1997, and this continues to

negatively influence attempts to pro vide state and community care for the elderly.

4. Summary
From the description mentioned in this chapter 1 can summarize that lack of

comprehensive social security and poverty faced by the elderly in Indonesia requires an

active response. 1 found that services so far are based on the charity model and do not yet

facilitate a level of empowerment and education for the elderly. Yet, the charity model

may construct people as dependent in order to receive help.

Secondly, although there is a national commitment reflected in the elderly welfare

act of VU No. 13/1998, 1 found there is little evidence of a "concrete" implementation of

this act which was designed to protect the life of older people in Indonesia. The case of

the elderly couple from Cirebon area who have not eaten for three days indicates that

poverty and social security are becoming serious and critical problems for older people in

Indonesia. In addition, because many participants in this study lacked knowledge about

the elderly welfare act, there is a clear need to inform this law and its benefits.

43
 CHAPTERIV
INTERPRETATION: HOW CULTURE, RELIGION,
AND GENDER SHAPE AGING IN INDONESIA

1. Defining Old Age

Before considering how culture, gender and religion shape conceptions of aging

and aging issues in Indonesia, 1 will briefly present an overview of how the 'elderly' are

defined in the society, particularly in the West. From there, 1 will define the concepts of

"the old" and "the elderly" in Indonesian context. These definitions provide the basis to

understand how various social locations may shape and impact the experience of aging.

Being 'old' is a subjective term. Bowers et. al. (1987) claim that the definition of

"the elderly" depends on the perspective of the pers ons involved. Sorne teenagers

perceive their 40-year-old parents as old. On the other hand, retired 70-year-olds may not

consider themselves elderly. However, a generally accepted definition of 'old' or

'elderly' refers to those aged 60 and over. Similarly, the Social Department of Republic

Indonesia refers to the elderly as those who are 60 years old and over (see also Dung Do-

Le, & Raharjo, 2002). This agreement of 60 is generally based on eligibility for social

policies:

1 guess a more general legal definition of elderly now would probably be sixty-
five years of age or older, when American begin to receive full Social Security
benefits. (Carter, 1998, p. 10)

It is important to note however, that chronological age is not to the only means by

which someone is considered 'old'. Lohman (1997) defines old age by using five

measurements: Chronological age, is defined as the number of years lived; Biological

age can be defined as either the objective assessment of a person's on health status or an

estimate of an individual's present position with respect to his or her potential life span;

44
Social age is a major organizing principle for social interaction, with the relationships

between age groups institutionally structured and regulated. Inherent to this system is an

unequal access to resources and to power based on social age; Cognitive age refers to a

person's self-identification with age reference groups; andfunctional aging, reflects the

relationship between biological maturation or deterioration and how weIl, if at aIl, an

individual can adapt and perform specifie physical, social, or cognitive tasks.

In the Indonesian context, the definition of "old" also depends on who defines it

and the "measurement" used. According to one participant in this study, if a pers on is

married and has children, they can be called "old". AdditionaIly, a person can be

considered "older" if they exhibit physical indications of aging as decline, such as grey

hair, cognitive loss or cognitive impairment, stroke, and the like. The functional

perspective holds that somebody may be called "old" if he or she has grandchildren

(whether or not they are biological grandchildren). For example, Nana, who is 25 years

old, is called the grandmother in her family. She has eight siblings and the oldest sibling

has grandchildren. Therefore Nana is automatically considered a grandmother or "mbah"

to her sister's grandchildren.

The definition of "old" and "elderly"26 also can be based on one's social role.

Sometimes the person will be called "syeikh" (taken from Arabie language, "syaikhun",

which means "old"). One participant illustrates that a 30 year old man, for instance, can

be called "syaikh" or "old" to demonstrate respect for his expertise in religious

knowledge and practice.

"1 think to define old is related to our interpretation of the Islamic

(or Arabie) teaching. They view the older people as a public figure,
therefore, in the history, for instance, a chairperson or an important

26 In bahasa, old means "tua", whereas elderly means "usia lanjut".

45
 pers on called "syaikh". It is from an Arabic language, "syaikhun",
and means "old (Hasan, worker ofreligious institution).

However, despite these social definitions of the elderly, the state bases formaI

definitions of the elderly on the Western conception rooted in age-based eligibility for

social policies. The Indonesian Act No. 13/1998, section one, article one, de fines "the

aged" or "the elderly" as someone who has lived for more than 60 years 27

The experience of aging however, is heterogeneous. The following will address

the cross-cultural aging issues in Indonesia and how the context of culture, religion, and

gender may shape the issues and experiences of aging.

2. Culture and Aging

McPherson (1990) suggests that culture and agmg are intimately linked. He

analogizes that they can be understood as reflecting different sides of the same coin.

While a society involves "sets of relationships," culture comprises "the meanings" that

develop when individuals or groups interact in these relationships. McPherson (1990)

also highlights the most important element in understanding the social organization of a

society: its values, beliefs, and norms. Culture, in the sociological sense, refers to the

social heritage of a society that is transmitted to each generation; it is learned behavior

that is shared with others (Harris & Cole, 1980). Understanding aging issues in Indonesia,

therefore, requires an effort to discuss the cultural context of the related values, norms

and belief in society in order to understand how conceptions of aging in the life of aging

population.

27Bab 1 pasal 1 UU No. 13/1998: Lanjut usia adalah seorang yang telah mencapai usia 60 (enam puluh)
tahun ke atas.

46
2.1. Family and the Elderly

The Ministry of Social Affairs states that Indonesia is a noble nation because it

has strong family ties which reflect its religious and culture norms about respecting the

role and status of the aged in the family and the community. Similarly, Nayar (1999) in

his study of the changing role of family in the care of the old in Indian society, states that

children' s responsibility for looking after aged parents was accepted and carried out in all

traditional societies. Accordingly, there is also culturally embedded norm about

respecting the elderlY and about the young's to care for the old.

Although caring for older people in Indonesia is generally the responsibility of

their children, where and with whom elderly people stay depends on the local norms of

our society. For instance, in North Sumatra28 society, the elderly people prefer to reside

with the oldest son in the family, whereas in Java society, older people tend to reside with

the daughter's family. Sons in Indonesia tend to have more responsibility than daughters.

However, both sons and daughters have a similar moral responsibility to care for the

elderly. Abikusno (2002), in his study of the socio-cultural aspects of the aged in

Indonesia, shows that most daughters provided more assistance and care for their parents

than did the sons (Batak region). He found that the eldest sons were economically

responsible for their older parents, and the daughters were in charge of care giving,

especially those daughters who lived nearby (Java and Bali region). Responsibility for

taking care of parents was placed on employed children, especially those living with their

parents (Bugisnese). Traditionally, in Indonesia there is a clear-cut division between the

Sumatra is the sixth largest island of the world and is the largest part of Indonesia. The Sumatra society
28
means the people who resides in this island but also who live within the tradition ofSumatra's

47
function of male and female children. Further, it is common knowledge in Indonesia sons

are responsible for financially supporting their eIder parents, while daughters are

responsible for caring for their elderly parents.

Family plays an important role in caring for the elderly (Nayar, 1999). Similarly,

Schroder-Butterfill (2003) found that family is widely acknowledged as playing an

important role in caring for oIder people in Indonesia. In Indonesia, the majority of

elderly people live with their family. So, ensuring a secure life for the elderly is currently

a family responsibility in Indonesia. As a result, people feel "reluctant" to place their

family members in a home for the aged (panti jompo). Instead, there is a belief that caring

for the elderly is one of the ways that young people can repay their eIders.

"In my hometown, there is no family who wants to put their elderly in the home
for the aged. They have a strong tied of extended family that will able to take
care of the elderly. Culturally, the existence of the panti jompo is unacceptable.
This is because, the younger family should responsible and to repay the oIder
parent" (Lia, caregiver).

ln general, there is a negative cultural views of institutionalization of the elderly

(e.g. to put the elderly in the home for the aged or ''panti jompo"). For instance, one

participant described this phenomena as unusual or "tidak lazim", shameful,

unacceptable, and taboo. The neighborhood will use it as a material for gossip, says Rian.

This is because children have a responsibility to care for the elderly as a repayment for

their past dedication towards their children.

"Budi ibu sepanjang jalan, budi anak sepanjang penggalan". Means that the
older/parent have longer time to dedicate their life for children, whereas children
have shorter time to dedicate toward them. These words teach them that children
have a shorter time to repay the parent, how come they want to put them in the
panti jompo and not care for them? (Rian, community worker).

48
 ln addition, the negative cultural views of institutional care for the elderly also

happened among the workers of the panti jompo. One worker participant describes that

she and her colleagues feel "uncomfortable" to see that family is "consciously" put the

elderly parent into the home for the aged (panti jompo).

"There is one family recently cornes to this panti jompo and "consciously" put
their elderly parent in this panti. However, 1 am still feeling that this is
unacceptable (taboo) attitude of the children to put their elderly parent here.
Because the case is that most of the dwellers of this panti are neglected elderly
people found by govemment in the public facilities and not because the family
who send them here" (Gusti, worker ofpantijompo).

Furthermore, according to Arie, it is impossible for elderly people to be neglected

III our society, as we have a very strong bond between children, parent, and their

extended family. Nuclear family is composed of husband, a wife, and their children.

When several nuclear families are joined together by an extension of parent-chi Id

relationships, this is called an extended, or three generation family (Harris & Cole, 1980).

We can take a look at the concept of our residential town where the family member lives

in the same neighborhood in order to look after each other (Arie, a community worker).

The tradition of familial support has bec orne intemalized among sons and other

family members. The intemalized values of mutual assistance and strong family ties le ad

children to feel guiIt and shame if they do not take on all of the responsibility for caring

for their elderly members. In addition, in our society, the elderly people compensate for

their retirement period by caring for their grandchildren. In most families, emotional ties

between grandparents and their grandchildren are strong.

"My parents (retirees) are living with my sisters' family. They are spending
more time to play with my cousin (their grandchildren), even we called them

49
 as a "baby sitter" in the sense that they care of them in which my sister and
her husband can work. The idea is not just because in my neighborhood there
is no adequate chiid day care but aiso more as achieving the idea of better
transforming our intergenerational values to our youngest family member,
such as controlling their development, behavior, and needs" (Ninie,
caregiver).

2.2. Community and the Elderly

Indonesian culture is weIl known for its values of community and 'mutual

assistance' (Mirpuri & Cooper, 2002). Mutual assistance is an important system where

everyone works together to achieve a common goal. It means that the entire community

has a joint responsibility to cooperate with each of its members. For example, Mak Ukik

(a sixty six year old woman who lives in the neighborhood) is childless, because she was

widow since she was twenty years old. However, she was never neglected, because her

relatives have taken responsibility for her needs (such as food, shelter, and sociallife).

Similarly, Rima (a 70 year old childless woman) lives on the care of and the

attention of the entire community. One participant claims that in the Malays' culture, this

type of care evidence of community and togethemess in the neighborhood: ones' problem

belongs to the entire family and community. Mostly, the neighborhood will support the

basic needs of elderly people, such as food, clothes, and shelter. However, it is interesting

to note that communal values in our society are mostly practiced in the rural areas. The

participants in this study wondered if the communal values would be difficult to find in

the urban areas such as in Jakarta and in any other capital city in Indonesia.

"In my neighborhood there is a 70 year old childless woman (Rima) is living

under the support of our neighborhood. 1 think this is evidence of the communal
values of our society, particularly the "malay" values. Means that ones problem
belongs to the entire family. But, 1 am wondering if there are more than two

50
 vulnerable elderly, will the community provide the same support? Also, is it the
same as what we see in the urban (city) areas"? (Lia, caregiver).

Moreover, in Indonesia all cultures advocate maintaining a good relationship with

neighbors and community as a whole (Abikusno, 2002). Abikusno (2002) points out that

many efforts to maintain a good relationship between neighbors should be

institutionalized in order to promote a just society for an age groups. This would not only

enable them to maintain a degree of care and prevents them from being demented, but it

also would encourage interactive dialogue between oIder people and the younger

generation. This is important for bridging the gap between generations and for providing

a forum for a better understanding of the problems faced by both parties related to

communication, idealism, and the sharing of immediate resources.

2.3. The Position of "Elderly" in Indonesian Society

In Indonesian culture there are social norms based on age. Harris & Cole (1980)

coined the term "age norms" to explain the social expectation of appropriate behavior for

different ages. These norms automatically become a "tool" to view each member of

society. Culture de fines what are approved and disapproved standards for our behavior,

and we judge behavior not by its logic but by its conformity to norms (Harris & Cole,

1980). In Indonesia, the view of oIder people seems to vary between that of respect and

stigma.

Cultural tradition in Indonesia normally provides adequate and sympathetic

support to the aged population. The elderly are located in the highest position, to be

respected, honored, and obeyed by the younger generation, and even placed as a source

51
of knowledge and expenence. The case of Mbah Jamar (eighty years old In the

neighborhood) illustrates this view. People in his neighborhood viewed him as the

"reference" pers on due to his knowledge, wisdom, and experience. People even perceived

him as a healer for their sickness. One participant explains that the Indonesian culture

views the elderly people as deserving respect 29 , holding wisdom, being a source of

knowledge and advice, and as having a "privileged" status. For example, the younger

people will ask the elderly people for their consideration before deciding things.

"In my neighborhood (ranah minang), the elderly people are seen as privileged.
The older people have the responsibility to provide advice, role model, and make
decision. In marri age, for instance, the elderly have an important position to
transfer or deliver the intergenerational tradition teaching, we called it ''petatah-
petitih" or advices" (Rian, community worker).

The elderly people also will be privileged in a ritual of marri age by being asked to

deliver the cultural and religious teaching or ''petatah-petitih'' to the younger generation.

ln primitive societies, where information must be transmitted orally and retained in the

memory, the aged person is the custodian ofknowledge, wisdom, traditions, and customs

(Harris & Cole, 1980).

On the other hand, the elderly are viewed as vulnerable people and this is

sometimes associated with prejudice and stigma. Hasan claims that stereotypes of the

elderly can be witnessed in the daily jokes in society, such as "Tua-tua keladi, makin tua

makinjadi" (to become older become the "better"). The negative meaning ofthis word is

that the elderly people are seen as "disengaged" from social activities. For example,

leisure activities (e.g. dancing and playing sports, etc.) are seen as inappropriate activities

29In our popular communities, respect for eIders is publicly demonstrated, such as to express our respect by
suitable greetings, we add "label" before their names: mbah, haji (a person who has been on a pilgrimage),
tuan, and the like.

52
for older people. Sorne older people have intemalized these views, for example, Agi

refers to her grandmother, Kamal (65 years old woman), who is reluctant to join social

activities or "fun activities" because she feels that she is an older person. She explains, "1

am already old, and it's not my time to join such this event". It would seem that the

experiences of aging vary significantly according to what people feel is 'normal' for their

lives. Consider the following quote:

"If the older person is dancing, for instance, people will consider it"weird". AIso,
there is an analogy of "tua-tua keladi, makin tua makin jadi". This sometimes is
positive, but sometimes it is negative. First, it can be positive, possibly because,
like the coconut, the older the coconut, the better. It means, as people become
older, there will be a social expectation towards the eIder to become "the er" -in
term of knowledge, experience, and attitude (Hasan, worker of religious
institution)" .

Similarly, Hasan, a participant, states that the elderly are viewed as "invisible"

people in our society. This is reflected in the general acceptance of the belief that elderly

issues belong to the domestic sphere (family and relatives) and not the public one. This

means, as discussed in previous chapter, the participant described the response of sorne

people in the parliament house (DPR) argumentation conceming on the legalization of

KDRT law. Therefore, govemment or public should not "intervene" in its people

personal business, such as conceming on elderly issue, domestic violence, and the like.

"1 feel sorne people still argue that the elderly are viewed as invisible in our
society. And overall, the elderly are culturally isolated, structurally they are not
supported by the social security, and socially they are stigmatized by the
community" (Hasan, worker ofreligious institution).

Similarly, the ambiguous views on aging are also reflected in people's

perspectives on the aged and the needs of older people. People often put the social

location of elderly in Indonesian society as significant and thus they ranked the problem

53
of elderly people as not urgent. This is due to the assumption of being aged as a natural

process. Arie, de scribe this example by using an anal ogy of the type of "care status" in

the hospital.

"1 think when we understand the social location of elderly people, we see the
types of care in hospital. For example, there is an "emergency" and "very-very"
emergency. 1 am wondering if maybe, elderly people are considered as important,
but not "urgent". It maybe due to stereotypes that "being older" is not a surprising
thing!" (Arie, NGO worker)

There is also a beliefthat the activity appropriate for elderly is to "repent". Sorne

people often associate being aged with close to death. Thus, people often associates death

advanced with aged, and therefore they expect to older pers ons to increase repent while

they are being old. This means that older people should prepare in facing death through

repentance in order to get etemal peace in their second life.

3. Religion and Aging

Harris & Cole (1980) claim that the close tie between religion and old age is

characteristic of not only primitive but also modem societies. Though religious

movements are often started by younger persons, religious leadership is mostly

concentrated among the elderly. McPherson (1990) argues that religious affiliation and

degree of religious involvement or commitment also influence, to sorne extent, the

process and the product of aging. Religion also influences attitudes and the status of the

aged.

Over the centuries, religion has had a dominant and far-reaching influence on

peoples' life (Azer & Afifi, 1992). Munir (2004) claims that religion is an important part

of Indonesia: it influences on the political, cultural and economic life of society.

54
According to the last census, the total Moslem population is approximately 88% of total

population, making Indonesia the largest Moslem society in the world30 (Munir, 2004).

Therefore, religion has a far-reaching impact on Indonesian society, from the level of

people's day to day lives to the level of government policy making. Today, Islam is the

most influential religion in the political and sociallife of the Indonesian people.

3.1. The Importance ofreligion in Aging

Harris & Cole (1980) claim that most of the available evidence indicates that

religion appears to be more important to older people than to younger people. 1 have

observed many religious based services and religious based activities for the elderly

people in Indonesia.

The role of religion among the elderly people can be se en as a support for life

adjustment and acceptance of the continuous decline along the aging process. Religious

teaching can be providing a source of strength and courage to deal with the uncertainties

of life. According to one participant, the older tend to have much more confidence in

dealing with aged related illness.

Mehta (1997) studied the impact of religious practices on aging and religion as

source of resilience. One of her findings was that the process of aging was viewed by

Malay Muslims as "the will of Allah", or God's will. It was a time for retribution ofpast

sins in preparation for the final end-death. In addition, the author explains that one of her

respondents' mechanisms for coping with headaches, for instance, was to recite twice a

religious verse (Kalimah Syahadah) which never failed to relieve him of his headaches.

30Although the Moslem is majority, the state constitution of the Republic ofIndonesia is Nationalist
Religious called "Pancasila", where the first principle is believe in God.

55
Rence, he consumed less medication, at the same time, saved on medical costs. Similarly,

religious beliefs and practices had an impact on the lives of Malays Muslims at the

personal level, in term of providing inner strength, and giving meaning to life at its final

stage, as well at as the social level in terms of providing guidelines for appropriate

interpersonal conduct, companionship, and the like.

The participants in this study explained that in Indonesian culture, religion has an

important role in shaping the relationship between family, community, and older people.

The influence was based on the teaching practice methods which are guiding the follower

to become aware and obey the role and obligation of elderly people both in the family

and in community.

"1 think both religion and culture are having the same role in influencing the
pattern of family care towards the elderlY people. The religion acknowledges the
younger people to repay their older parent investment during their young aged.
This as what 1 observed from my Grandmother attitude and my society attitudes
towards the elderly" (Agi, caregiver).

The religious teachings also provide an important role in social activities for the

elderly. One participant mentioned that in his neighborhood (and in Indonesian society in

general) many social activities are conducted based on religious practices. For example,

the elderly people are the most actively participants in the "arisan" or "maj/is taklim".

This activity helps the elderly people to socialize and to maintain their relationship with

their peers in the neighborhood. This is also provides meaningful time for them to

exchange knowledge and experience for facing life. The other significant role of this

activity is that the elderly people are encouraged to reminisce with each other about their

past experience, nostalgia, and life story. Religious institutions provide the aged with a

network of friends and fellow shippers (Azer & Afifi, 1992).

56
 In addition, the arisan and majlis taklim can function as an income source for the

elderly people. One participant described her mother's experience when she became a

religious teacher (guru ngaji dan penceramah). For this position, she received (financial

or material) as the compensation from the members (jamaah) of the religious community.

Furthermore, religious activities are also source of comfort (Azer & Afifi, 1992). One

participant mentioned that in Indonesia there are many public figures (celebrities) who

disengaged from their "glamour" and "free life style" and repented and are now enjoying

religious practices. They are only sorry that they did not do so in the past.

"1 observed that there are many public figures or celebrities in Indonesia who
leave their "glamour" and "hidup bebas" (free life style), such as Titik Puspa and
Gito Rolies. l heard that they argue that there is no choice involved in being aged
and being more close to religious practices, but also, they find that they are
repenting and feel sorry about what they did not do it in the past" (Agi, caregiver).

When asked about the influence of religion and culture on the way people care for

the elderly, sorne participants answered that both are interconnected and interrelated in

shaping the values of Indonesian society. Religious values and local community

traditions are having the same role to encourage people (and family) to care for elderly

people. In Bali, for instance, the "tri rene" (tiga hutang) or three debts to God, ancestors,

and older people is the religious teaching that support people to respect and care for their

older people.

"The religious values and norms are the most significant role to support elderly
welfare among families. Such as the teaching of "tri rene" (tiga hutang) or three
debts: debt to God, dept to ancestors, and debt to older people" (Noveria,
researcher)31.

3\ Taken from Prosiding Semiloka "Pengembangan Pusat Pelayanan Lanjut Usia-PKBI, Jakarta, October 2,
2001.

57
 Conceming the responsibility of the younger generation (children and family) to

take care of the elderly, participants claimed that the existing traditional norms and values

resulted from implementing the religious laws.

"1 think both have the same role. However, 1 will say that religious teaching has
the first impact to create the tradition or culture. 1 mean that because we
implement the religious practices, so gradually become tradition. Also it is
because there is an intergenerational teaching on transferring this attitude" (Ninie,
caregiver).

In addition, other participant described that:

"In my culture (Minang or Padang), for instance, people describe the relationship
between religion and culture using the jargon of "Adat besandi syara " syara 1

besandi kitabullah". It is unwritten values or laws that between the culture and
religion having the similar pattern/role in our life" (Rian, community worker).

This phrase means that the cultural tradition of our society is based on the

religious "laws", while the religious laws are based on the Holy book (Qu'ran). From this

view, therefore my participant argues that there is hierarchical role between religion and

culture. Religion shapes peoples' attitudes and norms because people are implementing

religious roles.

3.2. The Misinterpretation ofReligious Practice

Culture and tradition in Indonesia are greatly influenced by religion and religious

beliefs. The development of a healthy society is the responsibility of both men and

women, and the role of religion in this respect is critical. Misinterpretation of religious

texts and religious intolerance however, often lead to conflict situations and the

perpetuation of the oppression of women.

Conceming the influence of religious misinterpretation on agmg people in

Indonesian society, Hasan tells a story of "endless love" from the Hindu tradition and

58
Moslem society. This story explains the never en ding 'loyalty' and togethemess between

husband and wife as a consequence of marri age unity. Although he does not explicitly

mention aging people, he mentions a "wife" and a "widow" (these concepts refer to older

woman) who is left by the spouse. Indeed, in my opinion, my participant wants to explain

how religion influences the way people perform their lives.

"In Hindu for instance, if the husband is died, the wife should be follow to die
too! Because the idea of "endless love". Or in sorne places, if the husband died,
the widow should be alienated and should be "isolated"! Isn't it similar what
happens in Islam, when the husband died, the widow is not allowed even to
wash her hair during the grieving days (forty days!) and she must be stay at
home as symbol ofher faith and love" (Hasan, worker ofreligious institution).

According to Subhan (2002), the patriarchal culture of the Indonesian society and

the misinterpretation of the religious teaching maintain the vulnerability of women social

status in society. Socioeconomically, for instance, there is gender-based discrimination

on women, where women are often exploited and controlled by men's interests. The

following themes will explain the relation between aging and gender in Indonesian

society.

4. Gender and Aging

4.1. Gender and Patriarchy System
Lloyd-Sherlock (1997) c1aims that in almost all developing countries the

proportion of older women is usually higher than older men. The BPS or the statistics

center (Abikusno, 2002) reports that there are 14.4 million elderly people in Indonesia

and 7.55 million are elderly women32

32It is cIear that the percentage of elderly women is outnumbering of the percentage of elderly men in
Indonesia.

59
 Within this, older women tend to bec orne "victims" of the patriarchal culture33

The culture shapes the understanding in society that women's role is in the domestics

sphere and men's is in the public sphere (e.g. politics). For instance, as a consequence of

this culture, many efforts still exist to alleviate and to minimize the role of women in

public sphere in the name of religion. As a result, women remain in the "second class".

Unfortunately, sorne women do not connect their "oppression" to gender inequality. In

his study of the position of women, Nayar (1999) states that the position of the elderly

women has been especially neglected due to their dual oppressions related to their age

and gender. This coincides with mainstream sociological theory which has generally

ignored the gendered nature of aging (Arber & Ginn, 1991). As a result, many older

women become more vulnerable along their aged process.

The fact that women marry at younger ages than men do establishes what is called

a "mating gradient", (women's "choice" to marry at young age contributes to economic

dependency). This can lead to women having fewer resources, fewer schooling

opportunities, fewer job experiences, and less income. These small differences

accumulate over time; the husband's job will be given priority. As weIl, the pension

income becomes the "privilege" of older men. Abikusno (2002) states that according to

the Central Statistical Bureau (BPS), one of the profiles of the older population in

lndonesia (1997-1998) shows that more elderly females (40 per cent) have no schooling

compared to elderly males (15 per cent) and more elderly females (30 per cent) are

illiterate compared to elderly males (15 per cent). Thus, older women experience

cumulative disadvantage, particularly when benefits are based on employer contribution.

33 Hartman (in Morgan 1985) defines patriarchy as a set of social relations which has a material base and in
which there are hierarchical relations between men, and solidarity among them, which enables them to
control women. Patriarchy is thus a system of male oppression of women.

60
 Women are far more 1ike1y to be 10ne parents than are men (Chappell et al.,

2003). The reasons are due to the (early) death of husbands or to never marrying. The

patriarcha1 system in our society sustains the burden on older women to become primary

"breadwinners" for the entire fami1y. Ibu Nani (65 year old), described by one

participant, found it very difficult to provide financial assistant for her family since her

husband passed away 21 years ago. She often sold her c10thes in order to be able to buy

rice for her fami1y's meal.

ln addition, older women are much more like1y to be widowed than men

(Chappell et al., 2003). For example, among Indonesians aged 60 to 75 years, more than

one-half of women are widows. This is due the fact that women live longer than men,

women tend to marry men who are older than they are, and women are 1ess like1y to

remarry after their spouse dies than are men. One participant presented the case of a

father who remarried at the age of 60 a year after his wife died.

"My father's reason to remarry beside there is a social pressure (from fami1y and
neighbor) to encourage him to remarry, he acknow1edges that himse1f needs a
woman or a wife in order to take care of him during his aged. He admitted that he
cou1d not able to do the dai1y activities without the support of wife" (Lia,
caregiver).

However, 1 found a contrasting illustration from the participant suggesting that the

case wou1d be different from a widow's perspective. She described her friend, who has

three chi1dren and is a widow. She argues that women will1ikely be reluctant to remarry

after widowhood.

"1 think the experience of my friend can illustrates beside there are no social
"pressures" from society to remarry among women, but 1 find mostly women
think more than twice to remarry" (Lia, caregiver).

61
 Lia argues that there are "unfair" attitudes and responses from family and society

to discourage widowed women from remarrying. Moreover, widows with children are

seen as less "attractive" among the widowers. There are certain rules or norms in society

that require that "widows" should be "alienated" and "isolated" from the public arena,

avoiding any "attraction" from another male during her grieving days.

ln addition, elderly women or widows are socially expected to perform the role of

care giving. Care giving work includes activities and experiences involved in assisting

relatives or friends who are unable to provide for themselves (Browne, 1998). Another

participant provides an example of her grandmother, who lives with her family. This is

because her mother is a daughter (although her mother is also 50 years old and has to care

for other family members).

"My grandmother lives with my family, although, my mother also is old and has
to care for the entire family member. 1 think older women often prefer to reside
with her daughters' family. This is not just because if she lives with her sons'
family, she wonders ifnot able to cooperate with his son's wife" (Agi, caregiver).

Similarly, 1 found many elderly women who live in Jakarta are burdened

psychologically and financially to care for their spouses who are physically frail and not

able to me et their daily basic needs. The patriarchal system of our society contributes to

the vulnerability of women elderly people. It can be said that care giving in Indonesia is

invisible, devalued, and is generally assigned to women.

Gee & Kimball (1987) claim that women's poverty is due to structural, rather than

individual factors. They argue that the economic situation for the future cohorts of the

elderly is dependent upon changes in the status of women in general in society. OIder

women are like "perennial plants- the roots of their poverty develop earlier in life and

62
come to fruition when they are old. Poverty among older women is simply the cumulated

result of gender inequality in the labour force and in society generaIly" (Neysmith, 2003,

p.66).

Browne (1998) postulates that the consequences of many of the issues women

face in their younger years become crystaIlized disadvantages with age. As weIl, she

argues that many of the problems faced by older women are a direct result of multiple

oppressions. Yet, until recently, the issues of older women were curiously absent from

the feminist agenda (Browne, 1998). In Indonesia, there many women's organizations

and movements exist that have neglected to raise the issue of older women in their

discourses and actions.

However, it is not only elderly woman who suffer from gender-based

discrimination. One participant argues that the truth is that the most vulnerable are not

elderly women but elderly men.

"1 argue that in fact, older men are facing more social expectation in our society.
Older men remain expected to bec orne the primary "breadwinner" for the entire
family member; while the elderly women stay at home, the elderly men should go
outside and work for eaming the family life" (Joko, NGO worker).

Similarly, he mentions that within society, elderly women are seen as more

vulneraOble and, as the result, they get more "attention" and "funding" from their

relatives and society. Whereas, for the male elderly, because they seen as powerful, no

one will help and provide assistance for their need.

ln the patriarchal Islam joint family, the oldest male member was the head of the

family. If he was unable to manage the family property, he could delegate this task to his

eldest son and still continue to be the head. This indicates that the old men in the family

63
had two distinct, though inter-linked, roles namely economic head and a social head.

Conversely, the problem for elderly women is not just a lack of personal income or

property in her name during old age. Studies have shown that elderly women have more

adjustment problems than elderly men (Bali, 1999).

4. Summary
This chapter suggests the strong influence of culture, religion, and gender on

agmg. There are positive influences benefits for elderly people life. For instance, the

influence of culture and religion are very significant to encourage people to view and

treat the elderly. However, there is also strong negative influence of gender for the life

older persons, such as due to the misinterpretation of the religious teaching, and

discrimination against women, especially in sorne areas in Indonesia who still holds the

patriarchal values.

CHAPTERV
SOCIAL WORK APPROACHES FOR OLDER PERSON'S IN INDONESIA

64
 This chapter reviews social work perspectives in relation to aging in society. This

also raises the questions about the possible approaches for social work intervention with

elderly people in lndonesia. Drawing on the interviews of participants and relevant policy

documents, this study highlights the importance focus on those who are poor, live in rural

areas, and are being neglected.

1. Social Work Perspective on Aging

The biggest and most vulnerable social work client populations are the elderly and

children (Bisman, 2003). However, focusing on older people is not popular with the

majority of qualified social work staff. Accordingly, unqualified staff worker with the

elderly and problems and solutions have been seen in predominantly practical terms. In

addition, in our contemporary society, oriented towards the young, attitudes towards the

old can best be described as ambivalent (Rowlings, 1981).

On the other hand, since its beginning, the social work profession has contributed

to efforts aimed at supporting the elderly in society. Social work's values and code of

ethics provide strong support for practices that simultaneously target multiple levels of

intervention. Related to its mission, values and ethical code, the social work profession

places particular emphasis on empowering vulnerable populations, including those who

are oppressed and the poor elderly population.

2. Possible Approaches for Social Work Intervention in Indonesia

The consequences of demographic aging (or reaching the age transition) in

lndonesia presents a challenge to social work practice in our society. While lndonesia is

starting to develop a more "professional" and "modem" vision of social work,

65
professional social workers for elderly people are still in limited quantity within

govemmental institutions and non-formaI social service agencies. One participant in this

study reports that in a home for the aged, for instance, none of the workers graduated

from a school of social work or have social work skills. However, they have been trained

to perform practical interventions, such as assisting with the daily life of elderly people.

Although social work as a profession has not been as "familiar" to Indonesia as it

is in the developed countries, the Indonesian social work profession is in the process of

establishment. With this process, social work is challenged to define and establish its role

in services and programs for the Indonesian aging population. This includes assisting the

Indonesian population as it prepares for the impact of globalization and capitalization,

and the resulting emphasis on individuals who are visibly contributing to the economy.

For example, the CUITent culture of respecting seniors (the elderly) may shi ft to the view

that seniors are no longer productive due to their retirement from the workforce and

therefore they may be devalued.

"The position of the elderly has been undermined by such factors as changing
values, growing individualism, smaller numbers of children, the migration of the
young to cities in search of employment, housing shortages in urban areas, the
increasing participation of women in the labour market, and the devaluation of the
knowledge and experience of the elderly" (Thursz et. al, 1995).

2.1. The Micro-Mezzo-Macro Model ofSocial Work

The micro-mezzo-macro model of social work seems to be the dominant model of

Western social work, and also seems relevant for Indonesia. At the micro level of

intervention, social work can play a role in addressing individual eIders' problems and

66
needs through model of a self empowerment. Empowerment is a social work process and

intervention that has been recommended for work with oppressed populations, including

with women (Browne, 1995). Browne (1995) reports that a review of the social work

literature indicates that empowerment has been characterized in basically three ways: as

an intervention and product, a skill, and a process. In addition, there are three levels of

empowerment:

At the macro level, empowerment is a means to increase collective political

power. At the mezzo level, empowerment is a tool for organizational and
administrative change. At the micro level, empowerment is the development of an
individual's sense of control without change in structural arrangements. From this
perspective, empowerment involves individuals, groups, collective political
powers, and organizational co-operation for structural change (Wells & Taylor,
1991: 251).

The concept and practice of empowerment has been interpreted in many ways. It

can mean "to make able" or "to give power to". And, in general, empowerment can mean

for a more egalitarian, democratic, and humanitarian social order (Thursz et al, 1995).

Jordan (2004) addresses social work's potential to emancipate and to increase people's

autonomy and opportunity, rather than to protect their negative liberty (this includes

freedom from interference from other individuals or the state). Browne (1998) suggests

that friendships, community connections, mutual aid and support groups, family support,

education, and peer counseling can enhance empowerment for the elderly. One

participant in this study mentioned several times the importance of empowering the

elderly in Indonesian society. He advocates for the need to increase and to raise the issue

of freedom and self-autonomy among the eIder people. He recommends this is in order to

achieve and to protect their rights as senior citizens in our country.

67
 "1 feel, to raise the issue of freedom and self autonomy is an important challenge
to empower the elderly people. For instance to protect their rights as senior
citizen, it's what 1 caU the "true" empowerment!" (Arie, NGO worker)

According to Arie, true empowerment requires that the elderly people themselves

initiate community organizing and build a social organization which will accommodate

their voice in society. This is important in order to ensure that oIder people do not

become "passive" by waiting for another group or institution to make them their target

group.

"1 think the true empowerment for elderly people is when they have their own
initiation to build social organization. Empowerment is can be achieved by
"Community Organizing", where the oIder people become the primary targeted
group" (Arie, NGO worker).

ReaUy empowering the elderly requires that the social worker re-examine the

intellectual and moral infrastructure that support our efforts to deal effectively with world

aging. Workers must focus on the ultimate source of aIl potency in human affairs:

consciousness, will, and belief (Thursz et. al. 1995). Furthermore, Thursz, at.al. (1995)

suggest that empowering the elderly means including them again in the human family as

full, functioning members. Churches, temples, mosques and other religious holy places

must play an important role in affecting this change. The aging of the population will

make new and unique demands on us. On the other hand, society as a whole will need a

new outlook, frame of reference, and value structure in order to see the elderly differently

than in the past.

At the mezzo level, social work can play a role in maintaining our local

indigenous tradition. Thisis one of the most important tasks for social work in Indonesia,

in order to strengthen the role of cultural tradition in caring for the older population.

68
Supporting this tradition involves encouraging people to treat eIders based on the belief

system, values, and norms that they used to.

Maintaining the local tradition also can involve supporting the social activities of

older people in society. For instance, social workers can support the ongoing religious-

based activities engaged in by the older people in the community, such as majlis taklim 34

(an informaI union for older women), and arisan 35 (a productive activity for older

people). These activities give the elderly advantages (as described earlier), such as: the

self-satisfaction that cornes from being meaningful to other people, increased activity,

being healthier physically and psychologically due to physical movement and positive

thinking, and a financial income generated from a position as a religion teacher.

ln addition, Indonesia has hundreds of cultures with different ethnicities and

language spoken. Each culture inherits a "unique" tradition to perform their lifestyle

based on their values and belief system. The Indonesian cultures (suku budaya) include

Java (Jawa), Bali, Batak, Sumatra (which consists of Melayu and Padang), Sunda and

many other cultures. As described earlier, each culture transforms their values based on

the importance of respect and care for elderly people. For instance, the Malay culture

(suku Melayu) honours the importance of community responsibility towards the

vulnerable elderly people. One participant 36 in his study explains the Malay cultures

belief that one's problems belongs to the community. This means if a member of the

community faces problems and difficulties, the neighbourhood is obligated to respond

and to help this person. Similarly, there is a local tradition in Padang (suku Padang) of

34 The religion based union, where the older women sometimes spend their time learning about religion,
and conducting social activities with their peers.
35 A collective regular social gathering whose members contribute to and take turns at winning an aggregate
sum of money.
36 She is from Singkawang (West Kalimantan), Indonesia

69
respecting elderly people communicated through the analogy of "budi ibu sepanjang

jalan, budi anak sepanjang penggalan". This means that children have a responsibility to

the elderly in anyway due to elderly's past dedication to them when they were young.

From that story, social workers should understand the importance of maintaining

local indigenous cultures in order to strengthen the role of local community to provide

support and help for the vulnerable elderly people. For instance, social workers may

validate and facilitate the sphere of cultural aspects in caring for the elderly people based

on their beliefs and values. Furthermore, the existence of social institutions based on

local community initiatives in our society will not only function to help the vulnerable

population, but also to facilitate a response to the emergence of social problems, such as

poverty.

Another type of mezzo social work intervention involves the community

organizing older people, while ensuring that the control of the organizing lies with the

'service user', workers and local people. For example, drawing on this approach, social
37
workers might establish and build a 'community based service' (Kelurahan based

service) in every district as a centre for social activity. Such a service would have

members sit on a commission without any formaI and bureaucratie 'intervention' from

the lurah (a head of village). This commission could be responsible to the District Board

Committee (Badan Pemerintah Daerah) and to society directly in order to create a real

'civil society' and grow our local democracy and autonomy. Ideally, this could prevent

the CUITent situation where elderly services or agencies are located in urban areas in

which the recruitment procedure is too 'randomly centered' on those found neglected in

37 is a political district administered by /urah (a person who leads that district or village)

70
the streets or public areas. Finally, there will be no neglected elderly anymore in our

society due to our readiness in every kelurahan to provide our best services to the elderly.

Community organizing (CO) refers to the entire process of organizing

relationships, identifying issues, mobilizing around those issues, and building an

enduring organization. This action can be pioneered by a worker by changing public

attitudes towards the elderly and also by stimulating the elderly to be more critical of

what they need and their rights as citizens. In addition, it is because behind every social

movement is a community or a network of communities. When these communities are

effectively organized, they can provide social movements with important benefits.

The macro level of social work intervention includes developing societal

awareness about the needs of elderly people in Indonesia. An important challenge for

social work is to help elderly people to gain accessibility and acceptability in society.

Raising awareness towards elderly issues in society involves dividing social work

practice into different layers: social policy, advocacy, outreach, as well as socialization.

Social workers may help to influence community policies and practices through

networking with other social workers, helping professionals, consumer groups, and

government officiaIs. Social workers may also be encouraged to engage in social action

in order to change macro level policies, such as outreach, advocacy, organizing, and the

like (Pierce, 1984). As well, the social worker can act as a broker, linking people with

available resources.

However, the most important challenge for the social worker is to conduct self-

help advocacy38, involving and integrating the targeted client (service consumers) in the

38Originally, selfhelp advocacy was used to help the mentally and physically disabled in order to assist
them to increase access of services (Gould & Ardinger, 1988 qtd. in Hardina and Holosko, 1991).

71
advocacy process. Through self-help advocacy, I believe social workers will able to assist

vulnerable elderly people in Indonesia with getting access to better food, shelter, welfare

benefits, or social insurance payments. Here, the role of the social worker is not only to

ensure the availability of services, but also to assist service users with developing skills

and knowledge in order to obtain benefits from public organizations. Because, according

to Hardina & Holosko (1991), the purpose ofself-help advocacy is to empower clients by

developing their capacity to advocate for themselves.

The other type of advocacy that may be practiced by social workers in Indonesia

is legislative advocacy or lobbying for laws or regulations that will benefit either the

profession or service consumers. In the Indonesian context, for instance, social workers

can organize the entire vulnerable elderly population through legislative campaigns to

increase social assistance for them. This is due to the fact that only certain groups of

elderly people benefit from social assistance. According to Hardina & Holosko (1991),

the big challenge for social workers is to become more concemed with understanding the

relationship between policy formulation, implementation, and practice and how this

affects the client they serve. Hardina & Holosko (1991) suggest that the sooner social

workers understand how to assist elderly clients at every level of advocacy, the better

they will be able to serve them.

Furthermore, social workers are challenged to address the values and belief

system by designing social policies that reflect values that will bene fit the oIder person.

Thompson (1986) claims that the ideological challenge for social workers is to locate

systems of beliefs and values within specific social formations (such as old age policy).

In addition, power struggles over ideology reflect dominant social relations and provide

72
the context for defining the issue of old age and aging and determining how policies

address this phenomenon in society (Estes & Associates, 2001).

In Indonesia, elderly people are receiving strong legal support to get their right to

social security and social welfare mirrored in social we1fare act No.13/1998. However, at

the practical level, there are many elderly people living in poverty, suffering

mistreatment, and enduring a lack of social support. Therefore, the role of the social

worker in Indonesia may be to help vulnerable e1derly people through advocacy and

outreach. Advocacy should aim to lobby policy makers to take into account the existence

and the voice of vulnerable elderly population. From there, social workers may stimulate

policy makers to conduct assessments in order to define the major needs and problems of

the elderly based on their own voices. Secondly, through outreach programs, social

workers may actively engage in educating the public about the laws protecting the

we1fare of the e1derly which are still "unfamiliar" among the elderly population. By doing

this, social workers may help older people to become aware of their own needs, rights,

and obligations as senior citizens. As weIl, they can demand that the govemment provide

services for their needs.

At the same time, social workers should able to develop public awareness and

public empowerment in order to stimulate society to critically examine their rights and

consider the question: is there a possibility of enacting a public pension fund for the

aged? Social workers can evaluate the financial budget spent by older individuals over

their lifetime. For instance, if a person is fifty five years old, he or she must have spent

hundreds of millions of Rupiah (IDR) in taxes. This raises the question: can he or she

73
possibly receive compensation or portions of this contribution for their financial support

during their retirement?

In addition, social awareness towards older people can be achieved through

intense socialization about the needs of elderly people in Indonesia. This would not only

be in the form of 'abstract' encouragement and information, but it may also invite society

to actively participate in that action. For example, social workers may collaborate with

the govemment to conduct an intensive public advertisement campaign about the need for

elderly empowerment. On the bureaucratic level, social workers should encourage the

govemment to stimulate society through very 'attractive' methods in order to invite

society's involvement in providing social services for elderly people. For example,

budget programs may be publicly announced to let individuals compete for contracts to

develop projects through well-planned agendas rather than having the govemment

directly appoint project officers and staff. As a result, the winning contractor will be

responsible for implementing their project in a way that is transparent to the public and

that provides better services for the elderly.

2.2. The 'Clinical' Approaches for Social Workers in lndonesia

The individuallevel of intervention or 'clinical approaches' may also be important

for CUITent social work practice with the elderly in Indonesia. This involves conducting

the assessments in order to define needs and interventions of individual. Assessment is

not merely an administrative task that requires fitting the elderly into predetermined

categories, but is rather a process of gathering and providing information that is

meaningful to the elderly and responsive to their problems (Bisman, 2003). Similarly,

74
Bisman (2003) argues that it is critically important that social work assessments with the

elderly be truly biopsychosocial in scope. This means that social workers are urged to

take into account the contextual background of the client, including the biological,

psychological, and social during the assessment. This is needed in order to help workers

to understand the range of factors affecting the elderly, including health issues, mental or

psychological problems and strengths, and the social influences on the client such as the

role and status of the elderly client in society.

The assessment may be completed by a range of people, including social workers,

policy makers, community members, as well as elderly people. The assessment may

include the question of access to public services, such as affordable housing, affordable

transportation, and an analysis of support at the policy and societal level. A fundamental

part of assessment is the definition and recognition of need, by both client and worker

(Rowlings, 1981). For instance, the most striking example ofunrecognized or unreported

needs among elderly people are found in relation to their health, especially if the elderly

person is very old or lives alone or with an elderly spouse (Rowlings, 1981). After

assessing the types of needs and major problems of elderly people, social workers then

prioritize these problems in order to identify the appropriate types of interventions.

3. Elderly Poverty, Social Security and the Role of Social Work in Indonesia
ln Indonesia, poverty is the major challenge for social work practice. Since

poverty is likely to become a major issue for older people, social workers should

prioritize their interventions in order to deal with this issue. Thus, the most applicable

models for social work practice in Indonesia may not be clinical or individual-based, but

instead they must be based on community or collective approaches. For instance, to

75
eradicate poverty issues, social workers should be able to strengthen the social

functioning of elderly people. This means social workers may be able to take a lesson

learned from the philanthropie approaches, characteristically based on "charity centered"

social institutions or agencies for elderly people. The need for encouraging the elderly to

take their place as active members of society means that older people should not be given

a "product" but they should be given "tools" (jangan memberi ikan, tapi beri/ah kail)39.

This also means that social workers may encourage government to address the core need

for universal provision of social security as weIl as to change the structural system in

which older person often se en as the 'vulnerable' and therefore only in need of 'instant'

support.

Social work strategies to eradicate poverty should focus on strengthening the po or

as active social participants (Suharto, 2003a). These interventions must not be targeted to

the individual, instead he suggests changing unequal social structures by providing skills

(such as fishing), minimizing the dominant ownership of the areas for fishing, and

extending access for fish marketing. Suharto (2003a) claims that, due to the complexity

of poverty in Indonesia, there is a need of inter-sectorial and inter-institutional

coordination in order to minimize the number of poor in Indonesia. For instance, the

Social Affair Department of Republic Indonesia should be able to build networks with

other departments.

Social workers, in my point of view, should be able to critically observe the

government attitude in dealing with social issues in Indonesia, such as those concerning

the dis aster response or emergencies responses. The les son learned from the tsunami

39An Indonesian analogy, which means "do not give fish instead of the plumb/tools". This is a wise way to
explain that the vulnerable people need tools and not (direct) or instant "food" in the sense they need the
knowledge or strategies to find food.

76
disaster of 2004 highlighted the complexity ofproblems for the elderly in our society. For

example, this dis aster showed us the importance of social insurance, social security, and

other social assistance for older people in particular and for the Indonesian population in

general. A universal pension system and universal health care system would probably

help vulnerable po or elderly people to be able to survive such disaster. Therefore this

may bec orne a priority for social workers, to provide a "comprehensive intervention" for

survivors who are suffering from trauma, stress, depression, and mental health problems

due to their multiple losses and the absence of social assistance. Limas Susanto, a

psychotherapist, claims that the effect of the tsunami on the population was the

development of acute psychosocial trauma. The populations most potentially affected by

this situation are children and elderly people, due to their lack of physical and mental

capacity for dealing with 'traumatic' events in their lives. There is also however, not

having the means to rebuild homes and me et basic needs in the wake of disaster.

ln addition, social workers may address the invisibility of elderly people III

society. Help The Aged International (2005) reports on the vulnerability of elderly people

affected by the Tsunami disaster in Indonesia. This report noted the lack of data on older

people. Elderly people seem to be overlooked due to age and gender discrimination. As a

result, elderly people are potentially not receiving relief supplies, monetary compensation

and access to services. As weB, elderly people are most likely to be excluded from the

housing reconstruction assessment.

Social workers may utilize an anti-discriminatory approach in order to achieve

equal treatment and interventions for aIl populations in Indonesia. Anti-discriminatory

approaches require taking into account an individuals' race, religion, age, gender, sexual

77
preference, language, level of disability and culture (Marshall & Dixon, 1996). This is

particularly important in lndonesia, due to the heterogeneity of its population. Anti-

discriminatory social work practice in lndonesia most likely requires that social workers

be more sensitive to gender, age, and the diversity of social status and class. There is a

gap between the "have" and the "have-nots" and this difference influences the attitude of

workers and service providers. For instance, poor people often face discrimination when

requesting social services. Therefore, social workers can play the role of mediator to

provide and to promote more equal approaches for caring for the vulnerable poor elderly.

For instance, President Yudoyono 40 mandated that the 77 hospitals around

lndonesia release the poor population from medical expenses. However, there are many

hospitals that do not obey this presidential instruction. For example, the local newspaper

reports that six of the selected ho spitais refused to accept poor elderly families. The role

of social work is to not only assist vulnerable poor elderly families, but also to "monitor"

these hospitals and assist older people gain access. Similarly, social workers may use this

approach to achieve a better social perception of older people, so that they move from

being the "forgotten population" to the "included population".

The other major role expected from social workers in lndonesian society is to

advocate for the availability of more comprehensive social security (jaminan sosial) for

older people. Social workers may expect to be able to coordinate with policy makers

(govemment) in order to provide the more univers al pension coverage for aIl citizens.

Although lndonesia is not a welfare state, social workers may encourage lndonesia to

leam from other countries that succeed in providing social security for people. Take

Sweden's for instance, although as a socialist country, that is able to provide assistance

40 The present Indonesian President (elected in 2004).

78
and evenly "life guaranty" for those who are old, disabled, or have had accidents. In

addition, social workers should be able to pressure government to prioritize the poorest of

the po or to get welfare assistance for medical care for instance.

4. The Role of Social Work for the Rural Elderly Population

The role of social work practice in rural settings is also becoming one of social

work's challenges in Indonesia. This is due to the high numbers of elderly people in rural

areas compared with those in urban areas. The rural elderly population is growing due to

the trend of retired elderly people returning back to the village. In my point of view,

because of the differences between the Indonesian rural setting and Western societies

(where most of the literature on social work is based), social workers in Indonesia may

anticipate designing more "unique" approaches for rural elderly.

Bisman (2003) acknowledges that the elderly who live in rural areas may face a

particular set of social support issues due to their geographic distance and consequent

mobility limitations. Marshall & Dixon (1996) suggest that social workers should be

encouraged to develop the knowledge and skills necessary for serving those who live in

more isolated settings. In rural areas, for instance, public services are less and less

available. This lack of services can isolate people and distance them from the services

and support systems that should be there to help. Marshall & Dixon (1996) encourage

workers to make services accessible in these isolated locations and to look to new and

different solutions to problems in order to meet the needs of village communities.

ln addition, social workers can employ the four theoretical models for

intervention relevant for practice with the rural elderly population as proposed by Bisman

79
(2003). In fact, it is likely that practice with the rural elderly requires that the social

worker draw from aU of them, including social support, family systems, group work, case

management and community practice (Bisman, 2003:).

"Such a mixture of macro and micro, the person and the environment, individual
change and social reform, meshes beautifuUy with serving the needs of the rural
elderly. Social work's breadth of domain can meet the diverse needs of this
population for advocacy and direct practice, attention to the family and to
community resources, interventions that include therapy and financial help"
(Bisman, 2003, p.39).

The concept of social support refers to the "perceived canng, esteem, and

assistance people receive from others" (Bisman, 2003, p.44). Support can come from

spouses, family members, friends, neighbours, coUeagues, health professionals, or pets.

There are three types of support: emotional (providing a sense of love, belonging,

reassurance), instrumental (providing tangible aid and services), and informational

(providing advice and feedback). In the Indonesian context, social workers may utilize

this framework to show the importance of mutual support, and the tradition of mutual

assistance. Thus, social workers may help the rural elderly to maintain their CUITent close

relationships and to draw on these relations as a source of social support.

Although this is not a big issue for the rural elderly in Indonesia, social workers

may help the elderly to strengthen reciprocal interactions that have developed within the

generations including links based on indebtedness, loyalty and reciprocity. For instance,

social workers may encourage each family member to validate and express their sense of

caring in order to strengthen parent-child relationships. Another important intervention

for rural elderly people, according to Bisman (2003), is group work. According to

Bisman, group work becomes a vehicle for members to create positive change outside of

80
the group setting. Reid explains that the purpose of group work is to help members cope

and reach a higher level of social functioning (Bisman, 2003). In rural areas, it is likely

that group members will know each other and that the group leader is the only unknown

member. In such situations, according to Bisman (2003), social workers are required to

gain the trust of the participants and to engage them through the development of group

rules, contracts and expectations. For instance, given that the elderly people in rural

settings in Indonesia are actively involved in religious groups activities (such as majlis

taklim, described earlier), the social worker may specifically look to this activity as a site

to develop a group and help members reach a higher level of social functioning. Through

religious-based activities or social-based activities, social workers may help elderly

people to: become "empowered", understand their own situation, control their aged

related issues in later life, increase self actualization in society, and the like.

The last relevant intervention models for the rural elderly population are the case

management model 41 and methods of community practice (Bisman, 2003). These

interventions are needed for social workers to help rural elderly people who may

potentially face the multiple losses of their family members. Social workers may help to

provide support and assistance as well as to link them with the resources available in the

city (especially given that rural areas often lack necessary numbers of professionals,

resources, and social services). This may be particularly true for the caregivers in rural

areas who potentially suffer from depression, isolation, and burden due to the lack of

social access and social support in rural areas. In general, Bisman (2003) suggests that

41Case management is a procedure to plan, seek and monitor services from different social agencies and
staff on behalf of the client.

81
social workers who practice with the rural elderly population must embrace the person-

in-environment perspective and target the biological, psychological and social domain.

5. Eider Neglect (Abuse) and the Role of Social Work in Indonesia

EIder neglect or abuse tends to be categorized in terms of physical, psychological,

sexual, and material/financial abuse and active and passive neglect. 1 feel that the formaI

conception of eIder neglect and abuse is a new phenomenon in Indonesia. It has not even

been documented publicly in our society. 1 feel this is due to the fact that the family and

the community in Indonesia hold the value of respect for the older people. However, as

described in an earlier chapter, the number of neglected elderly people has reached a

significant percentage in Indonesia. 1 feel that social workers should be aware that due to

our communality, the vulnerable elderly people are at risk of neglect by family members,

the community and policy makers for the childless, poor, and uneducated elderly people.

Social workers may encourage and develop resilience skills for aH older

individuals in society, particularly for those are often involved in care giving.

Components of resilience include safety and support, and affiliation with others that

includes individuals, groups, and communities (Ross et al., 2003).

Social workers should also educate society by conducting media "campaigns"

targeted to rural villages. For example, a retired person or couple may be encouraged to

retum to their home town or village in order to invest their physical and financial savings

in their neighbourhood. This strategy hopefully helps to address the increasing numbers

of neglected elderly in urban or metropolitan areas. These rising numbers were

exemplified for me when 1 was in the panti jompo in Jakarta, where 1 found that the

82
dwellers were mostly those who are randomly found neglected and begging for food in

the public areas and streets.

Education is a key concept in the prevention of abuse and neglect (Chappel et al.,

2003). Through education (both formaI and informaI), social workers could encourage

the elderly as weIl as society to understand aging issues. Social workers may be

challenged to assist elderly people with knowledge and education conceming the eIders'

rights in society. As weIl, the elderly need social work assistance to support their ability

to empower themselves to be free from exploitation and abandonment.

In addition, social workers may socialize the public about the importance of

family awareness of elderly rights in family relationships. People should be encouraged

to be more open in dealing with aging people and its related issues. Social workers should

understand that family members are potentially able to neglect and abuse their eIders due

to the intensity of their daily relationships and issues of dependency. Here, the role of

workers is to facilitate "respite care" for caregivers who have no compensation for their

care giving work. Social workers may encourage community agencies to provide services

that would allow caregiver's time away from the difficulties related to care giving (Ross

et al., 2003). Furthermore, social workers may encourage community members to provide

social accommodation for the elderly and caregivers, such as day centers, drop in centers

and the like in order to reduce the potential risk factors of eIder neglect and abuse in

family and community.

Social workers may be encouraged to play a role in preventing eIder abuse and

neglect in society. This can be achieved through the involvement of workers and family

members, as weIl as the service providers, to develop rising awareness, education,

83
research and the collection and dissemination of information. From there, social workers

can be expected to be able to identify the appropriate types of intervention for eIder

neglect.

6. Summary
This chapter discussed the possible approaches for social workers working with

the elderly in Indonesia. This includes the micro-mezzo-macro levels of social work

intervention in Indonesia and the individual level of intervention such as assessment.

Although many may seem more applicable to Western societies, I believe social workers

may apply these models in the Indonesian context. For instance, in order to work in the

area of aging issues in Indonesia, social workers must understand the different layers of

intervention required of them, including individual-based interventions, group-based

interventions, and community-based interventions. In short, the micro-mezzo-macro

model can guide social workers as they work to empower elderly people as individuals;

promote the importance of local indigenous tradition to maintain elderly in the family and

in the society; organize community members in order to provide better services for

elderly people; advocate to sensitize the public about the need of elderly people; and

lobby policy makers to formulate and to implement social policy benefits for elderly

welfare in Indonesia.

In addition, I have identified the three major issues that social workers may

prioritize in their interventions with elderly people in Indonesia: the poverty issues facing

elderly people in particular and Indonesian population in general; the need for addressing

the problems of elderly people in rural areas (such as lack of access to service and

support); and the need for prevention and intervention program for the neglected elderly

84
people in society. This chapter also emphasized that social institutions and social services

for the elderly need qualified and professional social workers in order to provide better

services for them.

CHAPTERVI

DISCUSSION AND CONCLUSION

1. Conclusion and Discussion

Indonesia is in a demographic transition that may result in a graying population.

The shape of the Indonesian aging population is like an "upside down pyramid"

(piramida berbalik), meaning that there will be more elderly people than younger people

in a few decades. This is due to the increasing life expectancy of the Indonesian

population as weIl as the decline of both mortality and fertility rates. The National

Planning Board (Bappenas) (2005), National Center Statistic (BPS) (2005), and the

85
United Nation Population Fund (UNFPA) (2005) report that in 2025, the Indonesian life

expectancy will increase to 73, 3 year from 69 in previous years42

"TomoITow's elderly are in fact today's working class adults. They are likely to
live longer than their parents and their knowledge of modern science and
technology stands to remain valuable to the society in general, making it likely
that the concept of older people as a burden will be reversed, in distinct contrast to
our present thinking" (Thursz et.aI. 1995: 185).

However, aging issues and its related problems so far, seem to be "invisible"

where aging individuals often bec orne the "forgotten" population in many ways.

Government or non-government institutions directed to elderly people provide few

programs or services available in Indonesia. Society views elderly people as vulnerable

people but at the same time hold values that elderly people deserve respect. Yet, the

elderly in Indonesia are no longer having their health and social support needs met due to

the shifting family structure from extended to nuclear. The increasing number of women

in the workforce is now another factor impacting the issue vulnerability of elderly people,

because women tend to be expected to care for older people.

The findings of this study examined four general themes: the major problems of

elderly people in Indonesia; the laws or social policies gui ding services for the elderly;

the influence of context (cultural, gender, and religion) on aging in Indonesia, and the

possibility of appropriate approaches for a social work practice in Indonesia.

The CUITent available social security scheme for elderly people in Indonesia has

been only available to people in formaI employment, big companies and military. The

existing scheme has not been successful in its ai ms to provide adequate social security

benefits to beneficiaries because of its low coverage, limited benefits, and low investment

42source- online news journal

http://jktl.detiknews.com/index.php/detik.read/tahun/2005/bulan/08/tgl/03/time/05411 /idnews/414832/idka
nal/IO

86
retums, combined with poor govemance (Arifianto, 2004). Therefore, the current pension

system in lndonesia undoubtedly needs evaluation and improvement (Wachmatawarta,

2004).

lnterestingly, the lndonesian govemment is currently proposing a more

"comprehensive" model of the National Social Security System (known as

''jamsosnas'' 43). This will replace the existing social security schemes of Askes,

Jamsostek, Taspen, and Asabri (lndonesian National Security Organisation, 1995). The

comprehensive nature of this proposed scheme means that it consists of an old-age

pension, National Health lnsurance (NHI), death benefits, and worker disability schemes.

It intended to coyer all lndonesian citizens, regardless of whether they are formaI

workers, informaI workers, or self-employed (Arifianto, 2004).

The second theme of this study describes the establishment of social policies or

laws conceming on elderly population needs in lndonesia. This stipulates in the Act No.

13/1998 about the elderly welfare. This law becomes the first step in our national

commitment to increase the quality of services for elderly people in lndonesia.

Govemment, social policy makers, social services providers, and any other types of

social organizations are encouraged to take responsibility for strengthening the life of the

vulnerable elderly population in lndonesia.

As a follow up of this law, there are initiatives, programs, as well as services

available for elderly people in lndonesia. The institution that has been mandated to

implement this law is the Social Affair of Republic lndonesia under the division of

elderly (department lansia). There are sorne successful programs as well as sorne

unsuccessful programs. The successful programs do not require further explanation in

43 The abbreviation of "Jaminan Sosial Nasional" which means "the National Social Security".

87
this study; instead there is a need for more critical Vlews of programs that can be

considered unsuccessful. Govemment programs and services are limited in terms of

coverage, implementation, and the characteristics of services delivered. This is due to the

"top down" delivery system in which the govemment has more control in over providing

services and policies. As well, social services seem mainly accessible for only certain

people in urban areas, while neglected elderly people in rural areas. Another finding in

this study recommended the need of areas and coverage extension of the elderly based

associations available in Indonesia to involve "lower-class" elderly people-based

associations.

The third theme of this study suggests that there is strong relationship between the

Indonesian context (influenced by culture, gender, and religion) and aging issues in

Indonesia. The unique characteristics of our culture which is mostly very communal and

based on values of mutual assistance influence the way people view and treat elderly

people as weIl as the way elderly people see themselves. The Indonesian culture, which

still holds the ideal of "the three generation under one roof', shapes the common belief

that to put elderly people in a home for the aged, for instance, is not permissible and even

considered "taboo". This is because the role of family in elderly care in Indonesia

remains a feasible solution for both economic and cultural reasons.

Similarly, from gender-equal based perspective, this study found the influence of

patriarchal culture in the life of elderly women. They are most likely more vulnerable

than their elderly male counterparts. Women in Indonesia tend to be "marginalized" and

bec orne a secondary class. This affects the economic status of elderly women who tend to

be poorer than male elderly people, because they have often been dependent, and lack

88
education, and lack income. The problems associated with ageing are thus more difficult

for women. Elderly women face multiple "problems" along their life span, which

accumulate from when they are young until their later life.

Religious belief systems influence the way people see and treat the elderly as

well. For instance, elderly people bec orne a children and family responsibility as a

repayment for their past dedication when they were young. Thus, few elderly people are

neglected by family members or relatives. Similarly, sorne charity and philanthropic

organizations are available in Indonesia, based on religious practice.

The last finding in this study shows that understanding aging issues in Indonesia

should become a priority for social workers. Social workers should be able to integrate

our local indigenous tradition in their social interventions. Thus, sorne relevant

approaches and models from the Westem context could not be "taken for granted" as

appropriate to adopt in the Indonesian context. This is very critical, due to the unique

tradition, belief systems, and local values, which shape how we treat and care for elderly

people. This study suggests that the most appropriate approaches for elderly people are

collective instead of clinical. Meaning that the community development and community

organization seen relevant to the areas of aging issues in Indonesia. This study suggests

that social workers may utilize the earlier described micro-mezzo-macro models in the

intervention. Nevertheless, this study suggests that social workers may later on focus on

the individual levels using need assessment and case management in order to define the

types of needs and intervention models.

One concrete idea to maintain the elderly in the community are to build an elderly

residence in one complex area. This is very important in order to rebuild the assumption

89
that homes for the aged are places for "isolation" and "exclusion" from the community.

In this complex area, policy makers and society can provide public facilities as weIl as

security areas. The govemment's responsibility is to provide subsidies in order to

maintain the infra and intra structure of elderly complex areas.

2. Limitations of this Study and Future Recommendation

l acknowledge this study has limitations and should therefore, not be generalized.

This is due to the limitations of the sample as weIl as the selected themes discussed in

this study. l am fully aware of my own biases in interpreting and analyzing the existing

data for the purpose ofthis study.

This is my first attempt to understand aging issues in Indonesia from a social

work perspective. It is beyond the scope of this study to focus on specifie issues of

elderly people in Indonesia (such as the implementation of the elderly welfare act, the

burdens of caregivers in Indonesia, and the like). This study was therefore limited to

revealing the overall picture of the policy and practice of elderly welfare efforts in

Indonesia. Further studies to de Ive deeper into the more specifie issues of this topic are

needed.

This study also suggests that the establishment of school of social work in the

State Islamic University or UIN (Universitas Islam Negeri) of Jakarta and Yogyakarta

should able to understand aging or the aged as one of service areas for social workers in

Indonesia through its curriculum and field work practice for instance. This is due to the

remaining assumption that the elderly are not a "favorite" topic among students.

90
91
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7
2. Who will the participants be?

The participants in the study inc1ude workers and volunteers, in the capacity of their job (For example,
deputy of elderly welfare of Indonesia, the director of the office of Social Rehabilitation Center of
Jakarta, and community worker). 1 plan to conduct interviews with workers from the following: (panti
Sosial Tresna Werdha (PSTW) Bhakti Mulia 01 Cipayung, Jakarta Timur (represents state institution),
Yayasan Emong Lansia (represents NGO based institution), Yayasan Amal Muliya (religion based
institution).

3. How will participants be recruited? (Attach copies of all written or spoken material that will be
used in recruiting subjects, such as newspaper ads, posted notices, verbal announcements.)

Letters of introduction and a short description of the proposaI will be sent to the government offices
mentioned above and the participants from "panti jompo" and NGOs.

1 will send this info by mail and email to directive agency workers asking them to identify the worker
with expertise in aging. 1 will ask them forward info to this worker and 1 will contact worker by email
(by telephone while in Indonesia). 1 will then contact worker and ask for their informed consent to
participate.

4. How will organizationaVcommunityjgovernmental permission be obtained (if applicable)?

Government permission is required to access the archivaI materials from the g overnment (law - legal
document). The archivai documents refer only to public policy documents stored at the "Badan Arsip
Nasional" (The National ArchivaI Agency). These documents are public however, special permission is
required under Indonesian government. (note: This is comparable to a public library in Canada- aIl public
documents for Indonesia are stored in the "Badan Arsip Nasional Jakarta). The requested document refers
to only UV No 13/1998 (mentioned in Question IlResearch Topic) and its guidance policies for
implementation. This 1aw (UV Nol 3/1998) i s the 1aw 0 n Eider Welfare in Indonesia set t 0 e stablish
guidelines for aIl policies and services for older people. This includes a five year plan for older people,
which is discussed each year on National Elderly Day (May 29). This document does not contain any
reference to individual cases, specifie organisations or agencies. It is a public guidance document.

5ince the Indonesia Social Equity Project, a joint program between the government of Indonesia and
CIDA, sponsors my studies at McGill University the letter from the project (as attached) should be
sufficient. As a student 1 am permitted to make copies and retain these for my MSW project in Canada.

As above, 1 will use the following to obtain permission:

1) Send short description of proposaI (by email)
2) List of potential participants (from director)
3) Permission from worker (individual)

5. How will data be collecte d, i.e., what will the participants be asked to do?

Individual meeting -interview guide (see attached)

This interview will be tape recorded and transcribed

For the interviews, in agreement with the participants, 1 will take notes that summarize the responses. 1
will also use a tape recorder to record my interview (see attached). The documents from government
offices, shelters, and NGOs will be sent directly to me in hard copy through the address of The
Indonesia Social Equity Project at:

320 New Chancellor Day Hall

3644 Peel Street Montreal QC
H3HIW9

6. Does the study pose any risks to participants? If so, please state why these are necessary and
explain how you plan to deal with them.

In the course of this research no elderly people will be involved directly. Interviews will be conducted in
capacity of their professional position and will not ask them to comment on their personal experiences.
Any documents containing names will be kept confidential. There is a slight possibility that participants
from government offices will feel reluctant to jeopardize their position, as weIl as participant from the
"panti" and NGOs will not wish to jeopardize government supports by being critical of the government.
Therefore, 1 will ensure that they understand that their response will be completely confidential.

Participation in this study is entirely voluntary. Individual participants will also be reminded of their
right to withdraw from interviews without penalty.

7. Does this study involve deception? If so, please state why tbis is necessary and explain how you
plan to deal with potential negative effects (e.g., by post-experimental debriefing).

Deception is not used in this study.

8. How will you document infonned consent to participate in the study? (Attach written infonned
consent fonn. If written consent is not possible, how will you document verbal consent? If it is not
possible to obtain infonned consent, explain why this is the case.)

In addition to verbal introduction, the informed consent is documented by a dated signature on the
relevant informed consent form(s). (See Forms D & E).

9. How will participants be infonned of their right to withdraw at any time?

It is written in the letters (see attached request for informed consent) and in the introductory remarks of
the interview that the participant of the subjects is entirely voluntary and that they may withdraw their
participation at any time.

10. How will subjectfdata anonymity and confidentiality be maintained?

Subject confidentiality will be maintained by using pseudonyms for the participants, and maintain
confidentiality in the fieldwork and interview process.

Material will be stored in a locked and secured cabinet at Indonesian Social Equity Project, accessible
only to myself and my thesis supervisor.

11. Please comment on any other potential ethical concerns that may arise in the course of the
research. If the proposed research involves testing subjects in situations where particular problems
may arise, please explain how researchers will be trained to handIe matters in a sensitive and
professional way.
1 will ensure that the workers understand the voluntary nature of the research and my role as a
researcher (a student). In recruitment efforts, workers will stress the voluntary nature of the study.

*Please Note:
re: process
As 1 am currently in Canada, 1 will begin the recruitment process by email. 1 am intending to conduct aIl
interviews in Indonesia between JuIy-August 2004.

re: culture and language

1 am from Indonesia myself and will be conducting interviews in my native language.
 Understanding the Issues of Ageing in Indonesia

Introductory Remarks (Verbal)

1 would like to say thank you for your time to speak with me today about your
experience in working with the elderly people in Jakarta. This interview is part of my
research for my thesis at the Master of Social Work (MSW) program at McGill University
Montreal. 1 hope my research and findings will contribute to the advancement and
improvement of intervention programs for elderly people in Jakarta and in Indonesia.
Before we moved on the interview, 1 would like to inform you that your
participation is entirely voluntary and that you may withdraw your participation at any
time. As part of the interview, 1 will be taking notes that summarize your responses and
if possible 1 will also use tape recorder. 1 will confirm the summary of your responses
and ask you if there are any remarks you would like to keep confidential or be left out of
the report. Your responses to the questions on government' s policy will he completely
confidential. This means that your individual responses for these questions will not be
identified. In general, all the information will be kept confidential.
Interviews will focus on three main areas: issues, laws, and services for older
people in Jakarta in particular and Indonesia in general.

1) Questions related to issuesjprob1emsjneeds

1. Could you tell me about the main problem or issues facing by older people in
Jakarta? In Indonesia? (E.g. housing, poverty, transportation, health, neglect, and
the like).
2. What do you see as the risk factors associated with this population and what
kind of programs should be implemented for them?
3. What do you see as the major barriers for the government in resolving the
problem of elderly people?
2) Questions related to lawsjcontext/policy
1. What types of services are aIready existed for older people in Indonesia? In
Jakarta?
2. What are the laws guiding these services?
3) Questions related to services
1. What do you see as the most challenging front for resolving the problem of
elderly people in Jakarta and Indonesia in general in the future?
2. In your view, what do you see as the risk factors associated with this
population and what kind of intervention programs should be provided for
them?

THANKYOU
 FORME

Understanding the Issues of Ageing in Indonesia

INFORMED CONSENT FORM

1 acknowledge that the research procedures have been explained to me, that 1
understand the study, and that any questions 1 had were answered to my
satisfaction. 1 know that 1 may ask any questions that 1 have about the study
procedures now or in future. 1 have been assured that information about me will be
kept confidential and that no information that would disclose my personal identity will
be released or printed.

1 have agreed that my individual interview contributions be audiotaped and

transcribed for analysis purposes. 1 understand that my participation in this study is
completely voluntary and that 1 am free to withdraw my participation at any time
without penalty. 1 am aware that 1 also have the right to ask to speak off the record
and/or to have part or ail of my tape erased. 1 have been given a copy of the
information letter.

1hereby consent to participate in individual interview.

Signature: Date: ___________________

Name (please print):

Siti Napsiyah

Known by Thesis Supervisor,

Prof. Dr. Amanda Grenier

Siti Napsiyah
McGili University School of Social Work 514-739-3836

Supervisor:
Prof. Dr. Amanda Grenier 514-398-7051
~McGill
School of Social Work Postal address: (514) 398-7070
Wilson Hall 3506 University Street Fax: (514) 398-4760
McGili University Montreal, PO, Canada H3A 2A7

Memahami Lansia dan Permasalahannya di Indonesia

FORMULIR KESEDIAAN

Saya mengakui bahwa prosedur reserach telah dijelaskan kepada saya. saya mengetahui
bahwa saya bisa boleh bertanya mengenai apa pun selama penelitian ini berlangsung.
Saya telah diyakinkan bahwa infonnasi mengenai saya akan dijaga secara rahasia.

Saya telah menyetujui bahwa kontribusi individual interview saya akan direkam secaraa
auditape dan ditranscribe untuk tujuan mempennudah analisa. Saya paham bahwa
partisipasi saya adalah benar-benar voluntary yang saya bisa sewaktu-waktu dapat
mengundurkan diri tanpa dihukum. Saya sadar bahwa saya juga bisa meminta untuk
mematikan audiotape jika saya mengungkapkan hal yang rahasia Saya telah diberi foto
kopi tentang surat infonnasi.

Saya bersedia untuk berpartisipasi dalam interview ini.

Tanda tangan: _ _ _ _ _ _ __ Tanggal: _ _ _ _ _ _ _ _ _ __

Nama (hurufbesar)_ _ _ _ _ __

Diketahui oleh,

Prof.Dr.Amanda Grenier
(Thesis Supervisor)

Siti Napsiyah
McGiII University Schaol of Social Work 514-739-3836

Supervisor:
Prof. Dr. Amanda Grenier 514-398-7051