When people grow old in traditional villages in Fiji, family and friends care for them at home until their dying days. In America, the elderly are more typically sent to nursing homes — a contrast that may appear unfeeling, even cruel. But the ways in which societies around the world treat their elderly span a vast and varied range, according to Jared Diamond, UCLA professor of geography and physiology.
Why this differs so drastically from culture to culture is an intriguing question that Diamond, 72, a Pulitzer Prize-winning author of “Guns, Germs, and Steel: The Fates of Human Societies” and recipient of a MacArthur Foundation "genius" award, is currently researching. Recently, he shared some of his thoughts on the subject with a standing-room-only audience in the Neuroscience Research Building auditorium in a lecture, "Honor or Abandon: Why Does Treatment of the Elderly Vary so Widely Among Human Societies?”
The idea that it’s human nature for parents to make sacrifices for their children and, in turn, for their grown children to sacrifice for their aging parents — turns out to be a “naïve expectation,” said Diamond. This assumption, he said, ignores undeniable conflicts of interest between generations.
From a common sense perspective, “Parents and children both want a comfortable life — there are limits to the sacrifices that they’ll make for each other.” And from a scientific perspective — natural selection — Diamond noted, “It may under some circumstances be better for children to abandon or kill their parents and for the parents to abandon or kill their children.”
Those circumstances include life’s often heart-wrenching realities — from the threat of starvation among indigenous tribes to the difficult choices posed by modern societies’ life-prolonging medical care, Diamond said.
Traditional nomadic tribes often end up abandoning their elderly during their unrelenting travels. The choice for the healthy and young is to do this or carry the old and infirm on their backs — along with children, weapons and necessities — through perilous territory. Also prone to sacrificing their elderly are societies that suffer periodic famines. Citing a dramatic example, Diamond said Paraguay’s Aché Indians assign certain young men the task of killing old people with an ax or spear, or burying them alive.
“We react with horror at these stories, but upon reflection, what else could they do?” Diamond asked. “The people in these societies are faced with a cruel choice.”
Those of us in modern cultures face cruel choices of our own, he added. “Many of you have already faced or will face a similar ordeal when you are the relative responsible for the medical care of an old person — the one who has to decide whether to halt further medical intervention or whether to administer painkillers and sedatives that will have the side effect of hastening death.”
Yet the fact remains, Diamond said, that many societies treat their elderly better than Americans do. In some cultures, he said, children are so devoted that when their aging parents lose their teeth the children will pre-chew their food. A closer look at how traditional societies value (or don’t value) their old people might teach us what to emulate and what to avoid.
The elderly’s usefulness in a society plays a big part in determining their fate, Diamond said. While old people in traditional societies can no longer spear game or battle enemies, they can still gather food to care for children. They are also often expert at making tools, weapons, baskets and clothes. In many societies they serve as “tribal elders” in medicine, religion and politics.
Perhaps most important, in cultures lacking written records of history, song and other forms of culture, older people are invaluable sources of information.
“The repositories of knowledge are the memories of old people,” Diamond said. “If you don’t have old people to remember what happened 50 years ago, you’ve lost a lot of experience for that society,” from communal history to advice on how to survive a cyclone or other natural disaster.
Societies also vary in how much they respect their old people — or don’t. In East Asian cultures steeped in a Confucian tradition that places a high value on filial piety, obedience and respect, Diamond said, “it is considered utterly despicable not to take care of your elderly parents.” The same goes for Mediterranean cultures, where multigenerational families live together in the same house — in stark contrast to the United States, “where routinely, old people do not live with their children and it’s a big hassle to take care of your parents even if you want to do it.”
While modernization has brought many benefits to the elderly — most notably improved health and longer life spans — it has also led to a breakdown of traditions. For example, multigenerational families are becoming a thing of the past in many modern cities in China, Japan and India, Diamond said, where “today’s young people want privacy, want to go off and have a home of their own.”
In America, Diamond said, a "cult of youth" and emphasis on the virtues of independence, individualism and self-reliance also make life hard on older people as they inevitably lose some of these traits. Then, there's America’s Protestant work ethic, “which holds that if you’re no longer working, you’ve lost the main value that society places on you.” Retirement also means losing social relationships, which, coupled with America’s high mobility, leaves many old people hundreds or even thousands of miles away from longtime friends and family.
Modern literacy and its ties to technology are also putting the elderly at a disadvantage.
“Modern literacy means that we look up things in books or on the Internet — we don’t go ask an old person,” Diamond said. “Formal educational systems, such as UCLA, replace old people with highly trained professors for transmitting specialized knowledge.”
And lightning-speed technological advances “mean that the things that old people do understand got technologically outdated,” Diamond said, adding that his ability to multiply two-digit numbers in his head has now been superseded by pocket calculators. He even admitted to having to consult his teenage sons to use the TV's “remote with 47 buttons on it.”
Still, steps can be taken to improve the lives of our elderly, Diamond said. Understand their changing strengths and weaknesses as they age, he advised, and appreciate their deeper understanding of human relationships and their ability to think across wide-ranging disciplines, to strategize, and share what they’ve learned.
“So if you want to get advice on complicated problems, ask someone who’s 70; don’t ask someone who’s 25,” Diamond concluded. “Old people can have new value … although we often don’t recognize that this is possible.”
His lecture was part of the Molecular Medicine Institute Seminar series.