At age 76, Carmen Ybarbo is settling into a new home. The grandmother of four and great-grandmother of eight recently moved to Lyons Gardens, a senior housing community in East Austin. She has placed potted plants on her porch table and is planning Christmas decorations to complement her navy blue front door.
In many ways, Ybarbo is like many elderly Latinos. Though she worked from the time she was very young, she is reliant entirely on Social Security to support herself in retirement. In other ways, she is different from many of her contemporaries. She lives alone.
“There’s a cultural preference in the Latino community to want to care for a loved one in the home, to keep them close to children, grandchildren and their community” says Dr. Jacqueline Angel, associate professor in the LBJ School of Public Affairs. “There’s a lot of tradition in the culture, but there’s also a lot of change within the population that may fragment extended family homes. Clearly, we’re going to see more elderly Latinos living alone.”
Angel’s research, much of which is done in collaboration with her husband, Dr. Ronald Angel, a professor in the Department of Sociology, examines health care and aging in our culture with a specific focus on minority populations. Her basic concern comes down to one question: Who will be responsible for elderly Latinos when they can no longer care for themselves?
Much has been made of the aging of the American population. Today there are an estimated 34 million elderly people in the United States. According to Census Bureau projections, by the year 2020 that number should increase to 54 million and by 2050, to almost 82 million. Elderly Americans could represent one in every five people in fewer than three decades.
Much has also been made of the rapid growth of the Latino population in the United States. Because of high rates of immigration, particularly from Mexico, and continuing high birth rates, Latinos will constitute the nation’s largest minority group by the year 2030. Until recently, however, little has been known about elderly Latinos.
Angel’s research seeks to remedy that. Among the many studies she has participated in is the Hispanic EPESE, a longitudinal study of Mexican Americans age 65 and older funded by the National Institute on Aging. It allows Angel to look at a variety of variables associated with health, aging and long-term care.
“Unfortunately, what we’ve found is that the Mexican origin population is economically disadvantaged,” Angel says. “And among elderly Latinos living alone, almost two-thirds are considered poor, and one-third lives below the poverty level.”
Carmen Ybarbo outside her home at Lyons Gardens
Many factors contribute to the compromised economic state of elderly Latinos. The traditional labor force disadvantage of Latinos has made it difficult for them to earn at a level to save money for retirement. They tend to work low-wage service jobs which rarely offer health or retirement benefits.
The impact of this is large. With fewer resources on hand than the non-Latino population at retirement, Latinos have fewer options for care in their later years. This is especially true for those who emigrate to the U.S. later in life and have limited access to public services.
“The accumulation of economic disadvantages can really place the elderly, especially the Mexican American elderly, at a very high risk for reliance on their families,” says Angel.
Reliance on the family is also consistent with traditional Latino culture, which places the family at the center of its identity. Latino family homes are often multi-generational, and as recently as the beginning of the 20th century, tradition held that the youngest daughter was responsible for the care of her mother and father until the day they died. Elder Latinos have historically lived in the home with their families. But demographic changes are beginning to make that challenging.
Caring for the elderly at home often requires that a family member—usually a woman—remain in the home. But very few families can afford to have adult family members not work outside the home.
“We know that women are more likely than before to stay in the workforce, even when they have children,” says Angel. “About three-fourths of Latinas between the ages of 25 and 54 work outside the home.”
Ybarbo’s history reflects these generational changes. In her childhood home in Austin, her Mexican-born mother stayed home and took care of the family. Ybarbo was a single mother and always worked outside the home. For 43 years she did display work, making papier-mâché and other decorations for Austin’s Harold Eichenbaum Displays.
Modern Latinos are caught in a predicament. They have a tradition of caring for their elders at home, and these elders need their care and have few other options. At the same time, they may not have the resources—either economically or functionally—to care for them. They may also lack the resources to finance alternative care.
“The people I’ve spoken with often express the guilt they feel with not really being able to be there for their families as much as they would like to,” says Angel. “All families want that level of support as we grow older. It’s a big predictor of whether we’re going to be able to have a healthy end-of-life experience. But for Latinos, there is a very strong cultural expectation for family members to be there.”
This is complicated by the fact that despite their low socioeconomic profile, Latinos have longer life spans than other minority groups. Unfortunately, they also have a higher incidence of some chronic illnesses, including non-insulin dependent (type-2) diabetes. Because they are less likely than non-Latinos to have private health insurance, they tend to receive a later diagnosis and a less aggressive treatment for diabetes, which greatly affects their ability to function in later years.
Today, elderly Latinos, especially women, are more likely than non-Latino whites to live with their children. Older immigrants who lack any significant personal assets or income often have no choice but to live with their children. And older Latinos are far less likely than other racial and ethnic groups to enter nursing homes. In a recent study, Angel and her colleagues found that less than 10 percent of older Mexican Americans use nursing homes, even when they suffer a decline in functional capacity.
The demographic changes facing Latino families and the projected increase in the number of elderly Latinos are likely to alter this in the decades to come. Angel hopes our nation can be better prepared in the future.
“It’s one thing to identify the problem,” she says, “but in a school of public policy, we want to come up with solutions, whether public or private, that can address these needs, and do it in an innovative way.”
The healing garden at Lyons Gardens
Angel’s recent research looks at the Medicare program and health insurance options for the elderly. She’s a proponent of Medicare, saying it has eliminated many of the disparities in care that the elderly receive. But she sees opportunities to improve the program, including making people more aware of qualified Medicare beneficiary programs. She also hopes to see an enhancement of the National Family Caregiver Support Program, established by the federal government in 2000.
“We want to empower our seniors and their loved ones,” she says, “and to get the federal and state government involved with the local communities. Organizations like Family Eldercare fill a gap in trying to pull together these different resources.”
Family Eldercare, a local nonprofit serving the needs of the elderly and disabled, sponsors Lyons Gardens, the community where Ybarbo now lives. Angel has been president of the organization and remains involved on the president’s council. Executive Director Karen Langley calls Angel an “inspirational and tremendous leader” in the organization.
Opened in September, Lyons Gardens is a national model for affordable senior housing. Built with federal grant money supplemented by other funds, it is designed to allow seniors to “age in place,” with design features that can accommodate residents’ physical changes. The 54 units are wheelchair accessible, built using green building design and materials, geographically close to stores, libraries and public services, and built around community spaces and gardens.
Lyons Gardens is open to households with at least one member who is 62 years of age or older and to households with incomes equal to 50 percent or less of Austin’s median income. Residents will not pay more than 30 percent of their income in rent and utilities.
If it succeeds, it will be looked to as a model for how the government and communities can work together to meet the needs of the elderly and take the pressure off of families in being responsible for their care.
“Addressing the unmet service and housing needs of the elderly of all races and cultures is far too important to our country not to deserve our serious attention,” says Angel.
Like Angel, Ybarbo is hopeful. Inside her apartment, she has set out lace placemats and photos of her daughter, grandchildren and great-grandchildren. She works an intricately patterned cathedral quilt. She’s still getting to know her neighbors, joking that it took a fire alarm to get everyone outside their apartments at the same time.
“But I think it’s going to be great here,” she says. “I’m thankful that people do this for elderly people so that we can at least have a place to go.”
Photos: Marsha Miller