Burial places

Hong Kong is very crowded by any standard—426 square miles of hilly land masses hosting a population of close to 7 million. We fight for a space of our own when we are alive, and our loved ones may still need to fight for a space for us when we are dead. I say “fight,” because I mean it.

Chinese people love to buy their own living space, instead of renting. Because space is at a premium here, housing occupies a huge percentage of people’s monthly income. Given the motivation to own their own apartment (not houses; few people in Hong Kong’s urban area can afford to own a house), people have to fight hard in life to make ends meet.

Recently, the way people “fight” in Hong Kong to get a spot for themselves or deceased family members hit the news headlines. Although burial is a Chinese tradition, nowadays it is no longer the norm. Burial land is scarce and, therefore, very costly and only for the privileged. More and more people now opt for cremation. But Chinese people believe it is not good to keep your ancestors’ ashes in your home. The forces of yin and yang will not be balanced; yin will be too strong. Urns should be kept in proper places, either in a cemetery or a columbarium (a place for the storage of cinerary urns). Public columbaria are not affiliated with any religion, but private ones are usually built and maintained in accordance with Buddhist traditions.

Because of the severe shortage of spots for urns, business-minded people have developed illegal columbaria. The problem surfaced when the government tried to put these illegal operations out of business. Unfortunately, there is no simple answer to the problem, even though the government intends to build more public columbaria. Nobody wants one in their neighborhood.

When I die, I would like to donate all my tissues and organs, if they are still usable, and then have my body cremated and my ashes used to plant a tree. I don’t need a tombstone or an urn. As society becomes more liberal, discussion of life and death matters becomes less of a taboo. Many elderly Chinese people do make plans for their funerals and burials. This is a good thing, as the family will be comforted to know that they have done what their loved ones wanted.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Social security in Hong Kong

In Hong Kong, when a senior wishes to apply for social security—locally, we call it Comprehensive Social Security Assistance (CSSA)—they have to sign a statement declaring that their offspring will not support them. What an infringement of a person’s rights!

Some people do not like to sign such a statement. Other times, sons or daughters will not allow their parents to make such a declaration, because doing so would not reflect well on them. In these cases, the poor, older person has to rely on the non-means-tested Old Age Allowance (OAA), a sum of $1,000 HK provided by the government to all seniors at age 70.

CSSA carries with it a social stigma. Many who do not want to apply for CSSA will try to live on the meager thousand dollars provided by OAA, which means an unimaginably hard life in a city like Hong Kong, where the cost of living is not cheap.

While surveys and research reports in the Western world show that most older adults have finished high school, studies here report that the mean number of years of education received by Hong Kong seniors is only two to three. Many of them do hard manual labor their entire lives. Hong Kong is an affluent society but, as in many advanced countries, most of the city’s wealth is possessed by a very small percentage of the population. Our older folks, in particular, are not well off.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Reverse ageism

Some of our students participated in a volunteer project, visiting seniors we believed to be “hidden” from society. They either lived alone or without adequate social support.

I went with one of the students to visit an elderly woman in her 80s. She was a nice, pleasantly plump woman who manages very well on her own. She can walk around independently, albeit slowly, and she can go shopping and attend medical follow-ups without assistance. She says she likes staying home, and hardly ever goes out. We tried to encourage her to join the nearby social center, which is why my student was sent to visit her. But she was clearly in possession of all her faculties, and knew what she wanted. She said she didn’t feel bored spending her time at home. She had worked as a maid/nanny her entire life. Although she lived alone, the children of her former employer, whom she had served for many years, would call and visit her every now and then. She had brought them up and was like family to them. It was clear that she was not depressed and was very much in control of her own affairs.

After speaking with her for a while, I came to realize that she was not in need of any external help. She did not like to join trips organized by the center because she didn’t want to make others wait for her. She did not want to spend more of her time at the center because she was the kind of person who didn’t like to be in lots of group activities. She was not what we would call a role model of active ageing, but she was self-sufficient. She was leading the kind of life she wanted and was not making any intentional efforts to isolate herself from others. She was not “hidden” from social services. She had limited social contacts, but this was, indeed, the way of life she intended to lead. Who are we to say that she needed more social contact?

With the hype about healthy living and active ageing in recent years, we have formulated notions about living and ageing, what active ageing means and how to go about ageing in an active manner. We have a stereotype for those we think have aged successfully.

During our 45-minute visit with this woman, I reminded myself once more that I must not let reverse ageism cloud my lens, that I should respect people’s choices of how they live their lives and that I must not impose what I believe is right on people who have experienced living a lot longer than I have.

I do believe there are multiple models of successful ageing. Active ageing is but one of them.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The luckiest generation

The first batch of baby boomers has been turning 60 since 2005, 60 years after the end of the Second World War. To my mind, the baby boomers—myself included—are the luckiest generation ever.

We were able to appreciate the world when it progressed at a much slower rate, and we are also able to adapt to the fast-moving world of today.

We are able to appreciate nature when we travel. We look out of trains at the scenery rather than focusing on our latest portable IT gadget, whatever it may be.

We appreciate the relaxed feeling that comes after exerting our physical body in vigorous exercise. We also like Wii, but do not use it to replace real exercise.

We enjoy life, and we also appreciate the virtue of hard work. While maintaining a good quality of life is essential to us, we also know the value of saving money in the bank. Statistics tell us that wealth accumulation is higher among baby boomers. We are also aware that the younger generations are more inclined to enjoy life, rather than being work-driven like their parents and grandparents.

We know about the joy of writing and receiving letters, but we also appreciate the instantaneous advantage of e-mail and are quite ready to use it or learn how to use it. We are definitely better at spelling.

Call it the bias of the older generations, but I do think we are better equipped to appreciate the arts and craftsmanship of older times. This is because we were brought up in a period when the world moved at a slower pace.

We have the best of both worlds—an older one and the current one—and I am grateful for that.

Having made these observations, I remind myself that, to better understand the younger generations, I must keep an open mind. As a researcher, I should know that humans are easily blinded by prior experiences and perceptions. I remind myself that I must not become so set in my ways that I am unable to see the virtues of generations other than mine.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Fair and chic

A nice tan is much pursued by ladies (and maybe gents) of the West, but it is not so for people in the East. While the tan of someone in a Western country may be the result of a vacation in some exotic tropical place, dark skin is undesirable in the East.

Have you ever noticed while traveling in Asia that women (and men too, sometimes) like to carry an umbrella with them to shade them from the sun? It is not only older women who do this, although they are more inclined to do so. Many younger Asian women are aware of the damage that ultraviolet rays will do to their skin. Lying on the beach or the balcony to enjoy the sun is not a common pastime for Asian women, unless they are very westernized. Fairness in complexion or, to be exact, whiteness of the skin, is valued a lot more than a nice tan in Asia, probably by both sexes.

If you travel in Vietnam, where a bike—motorized or non-motorized—is a common vehicle for commuting, you will see women wearing long detachable sleeves on their arms. The same if you visit Japan; you will come across many women wearing large-brimmed hats and detachable sleeves on their arms while taking a stroll in the park.

While a tan on someone in the West may indicate affluence, in the sense that they have taken a vacation to enjoy distant beaches and the sun, it may imply something different in the East. Traditionally, only Asian women who are from the working class need to work outside of their home and be exposed to the merciless sun.

There is a saying in southern China that mere whiteness of the skin is capable of masking three counts of ugliness in a person. So there you go.




For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Reflections on student learning

This semester I am teaching a course, “Nursing older people.” One of the assignments I have for my students is to write a reflective journal about any issue pertaining to elderly people and elder care, to be submitted at the end of the semester.

I thought it was an easy enough assignment but, to my surprise, my students do not think so. They tell me it is a burden to them. Quite a number of them say that they don’t know what to write about or how to write it. Again, this is a surprise, because these are third-year students, and reflective journals should not be new to them.

In response, I have modified the assignment with regard to it being a requirement, but have not removed it as part of the course assessment. To me, it is important when studying gerontology to cultivate sensitivity toward elder care issues. The best way to do that is not to write a paper or take a test, but to reflect, over time, on issues pertaining to elder care. Gradual sensitization to elder care issues through the writing of journals will help students develop awareness and insight about care of older people and, I hope, enable them to develop their own perspectives about the study of aging.

But this is not an age that encourages reflection. We humans like to fill our world with sounds. We are so uncomfortable with quiet moments that we try all means to drown our senses.
We need to be entertained every single moment. As soon as we arrive home or check into a hotel room, we turn on the radio or TV. We are defined by the latest electronic gadgets and games, by the PSP, iPhone, iPad and so on. We must have music constantly, whether it comes from an iPod or any other means. We can’t be bored.

We also can’t bear not being connected, even for brief moments. We have the Blackberry, 3G phones, WiFi, etc. Everywhere we go, we want immediate access to the Internet.

Because we are so busy entertaining ourselves, engaging in dialogue with people we know or don’t know, being reached and reaching out to othersand accessing information for all realms of our lives, the time that remains for reflection and recollection is very limited. Although Schön’s seminal article on reflective practice was published in 1987, more than two decades ago, fostering reflective practice nowadays runs counter to modern techno currents—not a very promising battle.

Personally, I need a lot of time to myself. I like people, but I also like solitude. Getting together is good to foster relationships, but getting close to myself and knowing how I feel and think is crucial to living a life that is meaningful to me.

I hope my students become, through repeated learning opportunities, better reflective practitioners.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Signs and symptoms of having had cancer

I thought having cancer hadn’t changed me much. But, as time goes by, I notice that, indeed, I have changed, although in less conspicuous ways.

Symptom 1: Becoming sentimental
I have become more sentimental. I notice that I am very much into taking pictures nowadays, much more so than before. I carry my camera around a lot. As time goes by, I realize that it is because I try to capture glimpses of my life, knowing that every small chunk of time is but a fleeting moment. These fleeting moments will, one day, add up together to make my whole life.

Symptom 2: Becoming more sociable
I have become more geared toward having parties and social gatherings. In the past, my project teams would just meet to discuss things. I rarely called for parties and get-togethers. But now I do. I used to enjoy time with myself—doing household chores, listening to music, reading books and magazines, watching television. Now I make more effort to be with others, and I make mental notes to remind myself how nice it is to be around people.

Symptom 3: Becoming more forgiving
Things students do that irritated me in the past are no longer as offensive. For example, I can’t tolerate it when students keep chatting while someone else is speaking, be it a guest speaker, other students or me. I consider this to be very rude. These days, however, when students still happily chat away in class, I am not as mad. I still ask them to please take turns to speak—between the speaker and audience, that is—but I don’t get upset like I used to.

I would say that these changes are for the better. And they are changes I did not quite expect. They must be linked to a reframing of my perspective on life after having cancer.

I hope they stay.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International (STTI).