San José, Costa Rica, since 1956

C.R.’s Adultos Mayores Face Uncertain Future

Fifteen years from now, Costa Rica’s senior population is expected to double.

No longer will the country’s over-65 population represent just 1 percent of the population as a whole, but that number is expected to climb to 11.5 percent by 2025. As Costa Rica’s average age gradually creeps up, some say the country is not ready for the demographic shift that will hit it in the coming years.

“The country doesn’t have the infrastructure to accommodate the elders,” said Mercedes González, a former professor who has spent the better part of the last decade in homes that cater to the elderly. “It takes too long to see a doctor, and facilities for seniors don’t have the capacity.”

Furthermore, Costa Rica needs to change its attitude when it comes to the country’s grandmothers and grandfathers, González said.

“There’s no longer any respect for adultos mayores,” said the 63–year old who has watched issues like abandonment and neglect sink many of her compañeras into depression.

“Our hair isn’t gray for nothing; it’s because we have more experience and more knowledge. Yet, young people nowadays don’t see that.”

Fernando Morales, director of Hospital Blanco Cervantes (one of four geriatric hospitals in all of Latin America) sees discrimination and abuse daily. He has an entire legal team investigating and responding to the more than 50 complaints he receives each week.

“There is not a culture in favor of (senior citizens),” he said. “And that has a negative effect on older people…That’s something that has to change.”

But, in terms of absorbing a larger over-65 population, he said the country will be ready.

“We aren’t ready yet,” he acknowledged, “but we are getting there.”

More a Baby Bust than Baby Boom

The aging population is a worldwide phenomenon.

In the developed world, the increase in the senior citizen population is attributed to the so-called “baby boom,” a result of war-torn countries searching for stability in big families in the wake of World War II. But Latin America was largely absent from WWII and, unlike Europe or the United States, it didn’t experience the same rush to produce children in the 1950s.

In countries like Costa Rica, the senior citizen growth spurt is largely a result of a longer life expectancy and fewer births.

Whereas in the 1950s, Costa Rican women were having an average of 7.1 children, during the following decade the number of children per woman dropped to 3.6.

“The average age began to increase as women were having fewer and fewer children,” explained Tim Miller, a demographer who works with the Center for Latin America and Caribbean Demography (CELADE) in Chile. “The resulting population is one that’s a little older than before.”

Miller has been working with leaders in various countries to help them develop a response to the aging population; one that emphasizes long-term planning in areas like healthcare, education and pensions.

“(The aging population) is a gradual, but unstoppable, change,” Miller said. “Nothing happens overnight, but, year after year, there are more and more elderly and fewer children.”

Costa Rica’s Response

Some people say that Costa Rica is approaching a crisis situation. Others soften their predictions about the aging population, saying that the change is slow enough to allow Costa Rica to make adjustments.

But all agree that it needs a proactive response.

The National Advisory for Older Adults (CONAPAM) has begun gathering statistics about Costa Rica’s over-65 population and implementing new programs, such as Movimiento para la Vida (MOVI), a collaboration among school-aged children, university students and seniors.

“The aging of the population will change – it has changed – the major demographic structure of the country, and that has implications socially, economically, etc.,” said Arodys Robles, director of the Population Center of Central America at the University of Costa Rica, who collaborated in some of the studies.

But the population shift is even more significant as it comes at the same time the country is adjusting to a changing homelife.

As more women and men solicit employment outside the home, their elderly parents are left alone without care. Many sit in their rooms without food, without help using the bathroom and without social interaction.

“There has long been a negative mentality toward (nursing homes.) People are reluctant to bring their parents here because they think it means they are a bad son or daughter,” said Sonia Valerin, head of a longstanding eldercare home – Hogar Carlos María Ulloa in Guadalupe. “But that’s changing as people are seeing institutions can sometimes mean a better life.”

A Forgotten Population?

For those seniors who dressed and bathed their parents and who remember dancing around their grandparents at home when they were younger, the institutionalization of eldercare has been a bit of a shock.

Although the country has long valued youth, many elders never expected to be left in the dust as their children and grandchildren chased materialistic items and better-paying-jobs, said González.

“In order to obtain more stuff, they work, and they leave their elders alone with many ailments,” said González, who moved to a nursing home due to family conflicts and medical concerns. “A majority of people who move to places like this (nursing homes), it’s by force…They come in normal and, little by little, they deteriorate until they become depressed.”

The abandonment and neglect no longer is an anecdote regarding the aging population; the country now has numbers to prove its reality. CONAPAM estimates that three of every 10 seniors are abused (physically, psychologically, or in some other way.)

Last year, more than 1,000 seniors reported being victims of abuse, with the most (176) suffering from abandonment or neglect.

“If we don’t fix this now, it will affect all of us soon,” said Emiliana Rivera, executive director of CONAPAM. “But it’s not only laws or a change in labor practices that will improve the situation. We need to create a culture of respect among families and society.”

In 2008, the organization received 51 reports of physical abuse, 162 reports of psychological abuse, 162 reports of patrimonial abuse (involving fraud or other scams), 131 reports of institutional abuse and 479 cases that fell outside the listed categories.

Women reported abuse more often than men, but those statistics are slightly skewed because women live longer, said representatives from CONAPAM.

The organization has been tracking reported cases of abuse since 2005, and it has noticed an increase in reported cases in the past few years. This is good news, according to officials, as it indicates more people are seeking help.

Not Unique to Ticos

Abuse, neglect and abandonment are not issues distinctive to Costa Rica. “This happens in the whole world,” said Morales. “Costa Rica is not alone.”

The same issues exist in neighboring Panama and Nicaragua but, unlike Costa Rica, those countries aren’t publishing similar reports.

Morales likened Costa Rica’s proactive stance in documenting issues of abuse to the influenza virus that has gripped the world recently.

“The number of cases of A(H1N1) flu in Costa Rica is now greater than 200,” said Morales. “Look at Peru. Three cases?…You want to know why Costa Rica’s number is so high in comparison? It’s not like we have more cases. We have just been proactive about tracing the virus. Peru? They don’t care.”

In fact, Costa Rica is in a better position than many other countries to confront the aging population, Morales said. It’s one of only four countries in all of Latin America with a hospital dedicated to treating older people, and health officials currently are setting up geriatric facilities in every corner of the country.

Costa Ricans enjoy a higher life expectancy at 79.2 years than almost every country in the Americas, which most doctors here attribute to socialized health care.

And Robles stressed that Costa Rica’s aging population is not one that counts down the days in nursing homes.

“This is not an age when people step out of life here,” Robles said. “The adultos mayores here are healthy and vibrant.”

Evaristo López, a farmer from Puriscal, sat on a outdoor bench at Hogar Carlos María Ulloa and thumbed through his paintings on a sunny morning in late June.

His eyes reflected a glint of pleasure and his smile carried a hint of pride as he showed off scenes of farm animals, flowers and fresh fruit.

The 78-year-old man, whose face is creased with age and whose skin is darkened from spending days harvesting beans under the tropical sun, no longer worries about putting food on the table or caring for farm animals.

“We have everything here,” he said. “Clothes, food, doctors…and I can do things here that I couldn’t do before…My family and friends have tried to get me to come home, But I tell them, ‘No, I want to stay here.’”


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