DOI: 10.1007/s10823-005-3799-2
Growing old in St. Lucia: Expectations and experiences in a Caribbean village
LISA S. KELLEY
Assistant Professor John A. Hartford Foundation Building Academic Geriatric Nursing Capacity Scholar, Adult and Gerontological Nursing, The University of Iowa, Iowa City, Iowa 52242-1121 USA
Abstract. In St. Lucia there are increased proportions of elders secondary to decreasing fertility and mortality rates and increasing life expectancy. The fact that people are living longer is a reflection of social success; however, increasing numbers of elders (often with chronic health problems) challenge family, social, health, political, and economic systems. Who will provide care and how this care will be provided are at the forefront of health and social service planning and debate. This paper describes the status of elders in St. Lucia. Expectations as well as current care experiences of elders and villagers are described.
Keywords: Community expectations, elder care, elder status, St. Lucia
Introduction
If your mother and wife are drowning I want to know which one saving?
But for me I rather my mother My wife she will have to excuse
For I can get another wife
But I can never get another mother in this life.
Lyrics from a Calypso song by Lord Kitchener a told by a village priest This paper explores the long held belief that elders are valued and supported in their extended families. Elders are said to be valued for their role in linking extended family ties and as proprietors of wisdom. Extended families have been described as a source of old age security (Barrow, 1996; Clark, 1966;
Powell, 1986; Rawlins, 2001; Rubenstein, 1996; Sennot-Miller, 1989). For example, Mesfin, Sinha, Jutsum, Simmons, and Eldemire (1984) in their re- search in August Town, Jamaica reported that 70% of elders lived with their daughters, sons, or a spouse and went on to say “the family appeared to be the main support for the older people” (p. 31). They limit family to vertically extended families, where older parents live in the household with a grown
child. While there has been considerable research and theorizing on descrip- tions and understandings of the Caribbean household and family, the primary focus has been on family structure, child bearing, and child rearing (Bar- row, 1996; Brathwaite, 1989; Clark, 1966; Davenport, 1968; Roopnarine, &
Brown, 1997; Sennot-Miller, 1989; Smith, 1962; Smith, 1975; Solien, 1960).
For elderly people in the Caribbean because of factors such as migration and economics, families that extend beyond a common residence may be more flexible and responsive to economic shifts than conjugal-pair-based families or household residences alone.
Using exchange and economic perspectives, researchers discuss how Caribbean women take care of grandchildren in order to guarantee them- selves some measure of financial, nutritional, and other support (Clark, 1966;
Massiah, 1986; Mesfin et al., 1984; Sennot-Miller, 1989; Shorey-Bryan, 1986;
Saint Victor, 1986). The strength of this expectation is supported by Powell (1986) who found that children were the second most frequently identified source of support for the middle-aged women respondents in the Women in the Caribbean Project (WICP). Children were spoken of as an indirect chan- nel for upward family mobility. Powell (1986) described what she called,
“sacrificial parenting styles,” whereby women invest in their children (e.g., schooling) with the expectation to reap some return in later years. Indeed, people in leadership and policy positions in St. Lucia also professed many of these same beliefs. For example, a priest explained:
In Caribbean. . . (we) speak of households, here we have the extended family, grandmother, great grandmothers, all living together under one roof and sharing a unit of social values with each other, one influences the other, happily together. There is a lot of security there because great grandma is there to help us link with the past and great grandchild is there to help us link with the future. In a sense, there is a real bonding of generations there. And there is a lot of security as a result of this kind of structure, psychological security, economic security, there is social security, and there is also spiritual security because great grandma will make sure that you go to church.
While this extended family is proposed to provide security to elders, it is also debated as only a “romantic myth” (Samariasinghe, 1982; in Sennot- Miller, 1989). To explore this belief, an 8-week ethnographic study was con- ducted during 1998 in St. Lucia, a small Caribbean island on which there were limited formal elder care services. The coastal village of Hillside (the village and all villager names are pseudonyms), with an approximate population of 4,000, was chosen. Hillside is typical of rural St. Lucia, with approximately
244 villagers aged 65 and over and 1,456 villagers under the age of 15.1 The island is classified as a young society with more than 35% of the pop- ulation under the age of 15, a median age of 22.5 years, and a dependency ratio of 0.68.2Yet, because of changing demographic profiles associated with projected fertility rates, life expectancies, and emigration rates,3 St. Lucia is changing from a high fertility, high mortality to a moderate fertility, low- mortality society4(Jn-Baptiste, E., 1998). St. Lucia is also transitioning from a bartering economy to an economy with an increase in exchange of currency for goods.
Methods
With the help of the community health aide (CHA), I conducted an informal census to identify people the villagers considered to be elders and to explore the belief that elders are valued and supported within their extended families.
In addition, I observed and interviewed these elderly people and their available family members. I visited six of these elder families at least twice each week for five weeks. I also conducted interviews and focus groups with community residents and community leaders. Interview questions that were constructed with the assistance of villagers included:
1. What is it like (to be/for) an older person in Hillside? How does one know someone is an old person? Who are the old people?
2. What is a typical day for an old person (who helps with what)?
3. What are important events (church, community, family) in Hillside?
What are important events (church, community, family) for elders in Hillside?
4. As (an old person/family member) what are expectations for elder care?
What was life like when you were growing up (elder care)? What was life like for your mother/father?
5. How have expectations about old people changed?
6. How are the old people in Hillside helped (family, church, community, government, and neighbors)? Who do you (older people) go to if you (they) need help? How helpful is this?
7. For care of old people in Hillside, please give a mark of very good, good, okay, bad, or very bad.
8. What could make care for older people better?
9. When you are sick what do you do?
10. Anything else you would like to tell me to help me understand about growing old in St. Lucia (help me tell your story)?
To access the perceptions of young children, the CHA and primary school principals assisted me in conducting a survey5 of 173 children in Hillside’s
primary schools. The school children’s survey consisted of the following questions:
1. Draw a picture of an old person.
2. Write a story about an old person.
3. What do you do with old people?
4. Do you want to be an old person? Yes/No. Tell me why you do or do not want to be an old person.
5. You become an old person when you turn what age or number?
Discussion
In this paper I describe the role and status of elderly people in Hillside. Then I explore elderly peoples’ sense of security within the family and community context.
Old people
Villagers speak of the “old people.” Those who describe themselves as “old”
focus on their capacity to carry out their daily activities independently. For example, an 81-year-old blind gentleman, who could no longer go to his garden or take care of himself, explained how a person knows they are old by the “way a person feels, if can’t take care of himself. . . I feel I’ve lived my time.” Although chronological age frequently was used by community leaders because of access to social welfare programs and retirement, even they referred to independence and functional ability. As an island leader explained, “old is an individual matter, and we are in no position to say to them, because you are 75 you should no longer be active.” For example, a 100-year-old woman is not considered old because she can still sew, cook, and walk to church.
In comparison, young adults and children describe an old person by the way they look and act. Physical characteristics such as gray hair and wrinkles mark the aged. Old people talk too much and get into other peoples’ business.
Young adults talk of how old people are “past their time,” they should “pack yourself in the corner there and give me room to pass.” An island leader spoke of how, “culturally we think of things that are so called old, that they should be thrown away and cast aside. We use the term vye’ as we relate to older persons, in a very derogatory way.” Acadius, a 36-year-old policeman, explained that:
My father is 72, and I would say he’s an old person. Once a man, twice a child. . . when become old, act just like a child, miserable and troublesome.
Troublesome is talking a lot and losing one’s mind. Acadius describes a woman:
. . . losing her memory. She not know what she’s doing. She come in the shop. She buy five boxes of matches in one day and she doesn’t know where she put it. . . when go to her home, 1000 nylon bags. Bring food to her, she not eat. She making worms!
Children6describe old people by functional changes, such as not being able to work, help themselves, and having to walk with a stick. Unlike the boys, the girls wrote about not wanting to be bent over, getting gray hair, wrinkles, or having their skin turning pale. A 13-year-old girl wrote:
An old lady is some body who is unable to do anything for her self. The lady is 85 years old. She live on her own, she has no children, her husband has already die. Her name is Ma LeLis. The poor lady is in a house by herself and can not see, hear, or walk properly. The old lady skin has plenty of wrinkles, and she is dressing in rags because she has no body to tell her that is not a good dressing.
Only 56 of the 173 children wanted to get old. Some considered aging to be a normal part of living. For example, one child wrote, “will have to do” if
“God don’t let me die.” A boy wrote because “children have 100% respect for you” and “mother put food for him.” Girls who wanted to get old wrote about “getting all the good deeds that I do for old people done for me” and
“when old have all the rest your want.” In contrast, 117 of the children did not want to get old. One boy wrote that he didn’t want to get old because
“you become ugly,” while another said “children will abuse me and make me feel depressed.” The girls wrote about not wanting children to laugh at them, call them names, abuse, or throw stones at them. Reasons girls gave for not wanting to be old included that people would tease them, hate them, trouble them, and not respect them. One girl wrote “no, because I would be worthless,” and another girl explained that she would not be able to “go out or take part in activities.”
Language use also influenced perceived status of old people. A child wrote of how they “laugh at the old people who speak in the old (Patois or Creole) ways and do not know how to speak right.” “Right” is speaking English, as they have been taught and mandated to speak in the St. Lucian school system.
An island leader explained:
The older St. Lucians,’ many are very Creole speaking. . . the younger persons are more tuned to an English mentality. . . many years ago to speak
Creole was to be low class therefore, the younger people shunned the older people because they didn’t want to be considered low class. . . (mothers) not speak Creole with them. . . mothers and grandmothers speak Creole, but not allow the child to speak Creole. . . it was demeaning.
Finally, many of the young girls wrote about not wanting to be all alone with no one to love or care for them. Old peoples’ religious status was strong and interwoven in all aspects of their lives, yet for many people, and women in particular, this hurt their standing among some members of the community.
Old people as proprietors of wisdom
Although children and adults reported old peoples’ cultural status as story- tellers, this apparently doesn’t happen as much now. One woman in her 50’s explained that in the past they would sit outside and tell stories at night. Now, since electricity came to the village in the 1970s, people stay in their homes and watch television. My observations revealed that most elderly people oc- cupy a low social status in Hillside. Villagers, none of whom were able to identify an old person who was respected or revered, confirmed this. I was, however, warned to be careful of some old people who were reported to have been stoned by villagers for being associated with black magic, or Maji nwe.
Maji nwe is power acquired from the devil by selling one’s soul, or the souls of one’s children. These old people are called gaje’ because they are said to be able to do evil to people, fly at night (even if they couldn’t walk during the day), and compel people to engage in antisocial behaviors.7 In the primary school survey, an 11-year-old girl wrote about her grandmother who walks with a stick, and whose hair was gray, features that “makes some of us children think they are witches.” This opinion was not limited to children. The Catholic Church, which built and maintained the Old Peoples Home in Hillside, had difficulty in hiring women to work. The woman who slept there every night reported:
Just doing it because want to, it doesn’t bother me, being with them. . . a lot of them (people) say they wouldn’t be able to work inside of here, at night, they say they (old people) do things to them at night.
With regard to labeling old people as gaje’ a social service worker explained:
And you know why, because of the changes that takes place, the wrinkles, the redness of the eyes, if your eye looks red it is because you have been gaje’ing all night and not sleeping. . . wrinkles, long face, all those aging changes that takes place is because (they) are gaje’. Somebody may be
senile, and walking down the road not knowing where he or she is going.
They will tell you, maybe it is because they have the devil with them A village priest provided some understanding of the link between physical aging and evil:
The perception is that old people are gaje’, they fly at night, they do all kinds of evil stuff,. . . Especially you old and go to church all the time, oh therefore you a witch. (This) is something that has been engrained because as they get old they look ugly, and anything that is ugly it has to be demonic; it couldn’t be of God.
In addition to practicing maji nwe, old people were described as practitioners of obeah practices. A religious leader explained that:
Obeah it is associated with more elderly people in our society. This is because they are closest to our forefathers from Africa who brought with them the old tribal way of trying to control their world. And so the old ones pass it on to their children, so the perception is, these old people, are obeah people.
Villagers describe obeah practitioners as both good and bad. Ostensibly their roles include healing, giving assistance in matters of love, and helping exam takers, however, they are reputed to be able to also do harm. Although it will require more study, the association of Maji nwe and obeah with elders suggests that it may be one of the sources of power that can be exercised by old people.
With regard to old peoples’ security
St. Lucia has become an increasingly cash-based economy, with less bartering for goods and an increase in exchange of currency for goods. Many young and middle-aged wage earners have migrated to urban areas or abroad. While the island has social welfare public assistance, it is only $40 EC ($14.80 U.S.) per month, and people must be in dire need to receive it. Furthermore, most of the old people are women whose place in the economy generated no savings and did not make them eligible for a pension.8Older men who had worked on their small farms and not acquired any pension or savings expressed the same concerns. This cohort of old people had not made enough money to do any more than feed their children. And, more important, although young adults spoke of how the old people should have saved money, old peoples’
expectations for their own old age did not depend on a personal money savings
account. According to many elders, especially women, old age was “what I had my babies for.” Similar to the findings of Powell (1986), although the expectation of filial obligations for care reciprocity was prevalent, many of the children who were nearby were poor themselves, others were abroad, in urban areas, or simply “no good.” Although some children were said to send money back, the amount of money was “small,” and it did not arrive with any certainty. It was common for women to speak of their children overseas, whom they had not heard from for over 6 months. One 92-year-old woman continued to “pray, trust God, and wait” to hear from her son who had gone to Washington, DC over 2 years ago and had not yet contacted her.
Furthermore, many of the middle adult population are economically marginal and challenged to provide care for children and aging family members. As one 52-year-old woman explained:
Life for old people, death, to the grave right now eh! What life they have, what future, what meal they have. . . they don’t have nothing! . . . You have kids there, what you can pay, where are the clothes you can buy eh, and the meals, milk. . . Okay, I want to give my Mum that dress, my chil- dren want something eh, where the money, the money small. So you say, well. . . Mum has seen her days, let Mum stay behind.
Most old people (that is, those who are dependent and in need of assistance) live alone. Although they expect their children to care for them, those without strong family support must depend on neighbors and the community health centre. For example, one confused man, Mr. Vincent, died of apparent mal- nutrition. He did not have family in the village, but lived alone in his house, immobile and severely cognitively impaired. His ex-wife’s daughter was avail- able to assist him. The time I saw him he was lying in his own excreta on a soiled bed in a dark room. His wife’s daughter was there to give him his cup of food (milk and bread) before she went back home to care for her depen- dent mother. Although she said she was “tired,” the CHA chastised her for not taking better care of him. Reinforcing the expectation that family should provide the care needed for old people the CHA told me “we not do her work and clean him, she lazy.”
Another woman, Ms. Dauphine, is a 92-year-old thin, nonambulatory, frail woman with a strong voice and determined eyes, who lives alone in a 4- room wood plank home. Ms. Dauphine has electricity,9but no phone, plumb- ing or toilet. Although she built her house, she believes that “acting like a man. . . caused bad obeah . . . . and (her) legs (to) not work.” Ms. Dauphine explains that she is “all alone now.” One adopted son (her nephew10) used to help, but she won’t let him help anymore because he “ruined things. . . now he comes and will give 20 EC about every fortnight.” On my first visit with the CHA, she told of how she had not eaten for three days. The CHA purchased
food for her. Although she says the neighbors “do not care,” they do, in fact, provide some assistance when she calls out loudly. A neighbor, Ann, claims that she helps Ms. Dauphine “from the heart (because) she (Ms. Dauphine) has no one.” On the other hand, Ann is free to reap the breadfruits from Ms. Dauphine’s tree. Furthermore, children and some adult members of the community regard Ms. Dauphine with fear as being gaje’.
Finally, the woman who receives what I observed to be the best care is Ms.
Catherine, an 85-year-old comatose bedridden woman who is cared for by her 65-year-old daughter, Ms. Brown. Ms. Brown never married, has no children, and has always lived with her mother. She is a strong Catholic and a retired government worker with a pension. Ms. Brown had difficulty learning to care for her mother, explaining it was “trial and error,” and she often felt isolated.
Yet, regarding her mother’s care, she “will not say burdensome . . . because my mother was a very nice person to me, and I feel what I am doing for her right now is a form of repaying for what she did for me.” Ms. Catherine has two other sons who live abroad. They call but do not assist Ms. Brown in the support of their mother in any other way.
These observations of elders in Hillside suggest that while the belief that old people are valued and supported in families remains prevalent, there is little evidence of stable family support or a respected position for old people, in particular those old people who are functionally or cognitively impaired and in need of assistance. All informants, from the young to the old people themselves, indicated that life for old people was “bad.” Many of the old peo- ple do not live with other family members, but alone. Old people, themselves, described their place as, “off to the side,” “bad, very bad,” and “finish.” An island leader explained how “suddenly you are not a bread winner anymore.
Even the way you are respected by other members of the family because you have become a liability, for the family and the community.” One frail de- pendent 88-year-old women, who received less than adequate care, spending most of her time in bed in a small back room of her home that she shared with her son, explained, “life is okay with relatives. . . the rest live like dogs on the street if there is no one there to take care of them.”
Conclusion
As the world ages, so will the population of St. Lucia. This increased propor- tion of elderly people (who often have chronic health problems and a need for care assistance) will continue to challenge St. Lucia’s family, social, health, political, and economic systems (Restrepo & Rozental, 1994). How their care will be provided, particularly in communities in which large proportions of the population are either under the age of 15 and hold elders in disregard, or middle-aged adults who are economically marginal and stretched to care for
large numbers of children and increasing numbers of elders;11constitutes a major social service dilemma.
Although in Lord Kitchener’s Calypso, mothers are spoken of as valued and, for the son, even of higher status than their wife when a crisis occurs, the belief in ongoing support of elders with chronic care needs was not substan- tiated in my short field experience on the island of St. Lucia.
Acknowledgments
The author thanks the islanders, especially Big Em Ki, who participated in this study. Sincere gratitude goes to Melanie Dreher and Kathy Clark for review of this manuscript. Thanks also go to Professors Meridean Maas, Toni Tripp- Reimer, Kathleen Coen Buckwalter, and Douglas Midgett. A shorter version of this work was presented at the Society for Applied Anthropology 1999 Annual Meeting in Tucson, Arizona. The research was supported by the National Institute of Nursing Research, NRSA F31-NR07255; T32 NRO7058, the New York Research Institute for the Study of Man, a Vivian Dahl Trunnell Graduate Fellowship from The University of Iowa, a T. Anne Cleary Dissertation Award, and a Myrtle Aydelotte Dissertation Research Award
Notes
1. In 1995 Hillside’s population was 3,691. Since age stratification data are not available, the most recent census data from 1991 showed the district, of which the village of Hillside is a member, had a total population of 11,168 with 737 of the people aged 65 and over and 4,406 aged 0–14 (Jn-Baptiste, 1998). For the village of Hillside this would extrapolate to 244 persons aged 65 and older (6.6%) and 1,456 children under the age of 15 (39% of population).
2. The dependency ratio is (0–15 year olds plus those over 65 years old). This is a crude indication of how many people are dependent on those capable of working. This figure is low, considering that not all people between the ages of 16 to 64 in St. Lucia are employed and capable of working. Furthermore, although many of those who do work provide direct financial support, many do not provide indirect financial support because they do not pay taxes. For comparison, during 1990 in the United States the median age was 33.1, with a dependency ratio of .52.
3. Migration data for St. Lucia is limited; however, during the 1991 census, net migration was estimated at -16,237 which imply that more people are leaving than entering the country (Jn-Baptiste, 1998). Although statistics on age characteristics of those leaving the country are not available, it is often the young to middle age persons who leave to seek employment in countries such as the United Kingdom and United States.
4. Total fertility rates have steadily declined, while crude mortality rates have dropped from 11/1,000 in 1961–1965, to 6.8/1,000 for the period of 1991–1995 (Jean-Baptiste, & Flachet, 1997). Consequently, in 1996 an estimated 6.1% of the population were aged 65 and over (Ministry of Health, 1997), that is an increase from 4.8% in 1970 (Jn-Baptiste, 1998).
5. The Primary Girls School Principal arranged for me and the CHA to visit six different classrooms to interview a total of 150 girls between the ages of 9–13 and one 15-year-old.
At the Boys Primary School we had a significantly smaller sample, because it was the last week of school and many boys were no longer in school. We surveyed 23 young boys between the ages of 9–13. A total of 173 children in the primary school completed the questionnaire.
6. Interestingly, 137 of the pictures drawn by children were of old women and 17 were of old men. This lends insight into old age often viewed as an issue primarily of old women.
7. A villager explained about an old lady who “saw a young boy walking down the road, and the boy all dressed so nice and lively—she sent (the) fellow (to) rape a lamb. And they send the fellow to jail, and she did (caused the boy to do) that because that boy have a self esteem (too high) and that (raping the lamb) would make the self esteem very low.” Another young woman went on to explain how “sometimes they give it in tea, in coffee . . . you don’t have to be old at all, but older is training the young person . . . passing it on from past.”
8. Now the island has the National Insurance Scheme (NIS) for young workers to help them prepare for their later years.
9. Her neighbor pays her electricity bill, which doesn’t come to more that 5 EC per month.
Ms. Dauphine explained that she tries to not use the one light bulb electricity.
10. Ms. Dauphine raised Samuel from the time he was 3 months old. She explained how one day his mother brought him to her to because she couldn’t take care of him. Ms. Dauphine took care of him and sent him to school. After his first communion (around the age of 9) she gave him his clothes and sent him to his mother. The mother brought him back. Ms.
Dauphine cared for him until he left on his own.
11. Women’s status as caregiver to grandchildren is an interesting area for further study. The role of grandparenting is discussed frequently in the literature, as well as by informants such as the priest, politician, and social service director. Grandmothers were indeed pro- viding much childcare for grandchildren whose mothers (and infrequently fathers) were either in the workforce, “no good,” or most often, abroad. It was interesting to note that grandmothers’ ages ranged from in their early 40’s, through late 80’s. The women with whom I spoke did not speak of this as a pleasure or means to meet their needs for fulfill- ment, but rather as something they had to do because there was no one else to do it. Some of these women spoke about the children as burdensome, troublesome, and the children’s parents as no good. The assumption that because they are caring for these children, these children will one day care for them was being questioned by some of the women caring for grandchildren. They have experienced being forgotten and not cared for by their own children. Consequently, some of them doubt and do not expect that these grandchildren will stay in Hillside to care for them.
References
Barrow, C. (1996). Family in the Caribbean: Themes and perspectives. Kingston, Jamaica and Oxford: Ian Randle Publishers and James Currey Publishers.
Brathwaite, F. (1989). The elderly in the commonwealth Caribbean: A review of research findings, Ageing and Society 9: 297–304.
Clark, E. (1966). My mother who fathered me. London, George Allen & Unwin LTD Davenport, W. (1968). The family system in Jamaica. In P. Bohannon & J. Middleton (eds.),
Marriage, family, and residence. (pp. 247–284). Garden City, New York: Natural History Press.
Jn-Baptiste, E. (1998). Population data: Age, sex, and households 1991. St. Lucia: Government Statistics-Census Office.
Jn-Baptiste, N. (1998). St. Lucia Demographic Trends. St. Lucia: Ministry of Health, Depart- ment of Statistics.
Jn-Baptiste, N. & Flachet, L. (1997, June). St. Lucia mortality report for 1996. St. Lucia:
Ministry of Health-Health Information Unit.
Massiah, J. (1986). Women in the Caribbean project: An overview , Social and Economic Studies 35: 1–30.
Mesfin, E.D., Sinha, D.P., Jutsum, P.J., Simmons, W.K. & Eldemire, D. (1984). Nutritional sta- tus, socio-economic environment and the lifestyle of the elderly in August Town, Kingston, Jamaica, 1984, Caribbean Food and Nutritional Institute Quarterly 20: 23–49.
Ministry of Health. (1997, December). Annual report of Chief Medical Officer. St. Lucia:
Ministry of Health.
Powell, D. (1986). Caribbean women and their response to familial experiences, Social and Economic Studies 35: 83–130
Rawlins, J. (2001). Caring for the chronically ill elderly in Trinidad: the informal situation, West Indian Medical Journal 50: 133–136
Restrepo, H. & Rozental, M. (1994). The social impact of aging populations: Some major issues, Social Science Medicine 39: 1323–1338.
Roopnarine, J.L. & Brown, J. (Eds.). (1997). Caribbean families: Diversity among ethnic groups. Greenwich, Connecticut: Ablex Publishing Corporation.
Rubenstein, H. (1996). Conjugal behaviour and parental role flexibility in an Afro-Caribbean village. In C. Barrow (ed.). Family in the Caribbean: Themes and perspectives (pp. 83–92).
Kingston, Jamaica and Oxford: Ian Randle Publishers and James Currey Publishers.
Saint Victor, R. (1986). Family relations and support systems. In P. Ellis (ed.). Women of the Caribbean (pp. 84–87). London: Zed Books.
Samarasinghe, S-W-R. (1982). Aging and the aged in Sri Lanka: A socioeconomic perspective, Unitas 55: 145–180.
Sennott-Miller, L. (1989). Midlife and older women in Latin America and the Caribbean: A status report. Washington, DC.: American Association of Retired Persons (AARP) and Pan American Health Organization (PAHO).
Shorey-Bryan, N. (1986). The making of male-female relationships in the Caribbean. In P. Ellis (ed.). Women of the Caribbean (pp. 69–73). London: Zed Books.
Smith, M.G. (1962). West Indian family structure. Seattle: University of Washington Press.
Smith, R.T. (1975). Class differences in West Indian kinship: A genealogical exploration. In A.F. Marks & R.A. Romer (eds.). Family and kinship in middle America and the Caribbean.
Leiden, Netherlands: Institute of Higher Studies in Curacao, and Department of Caribbean Studies of the Royal Institute of Linguistics and Anthropology.
Solien, N. (1960). Household and family in the Caribbean: Some definitions and concepts, Social and Economic Studies 9: 101–106.
Address for correspondence to: Lisa Skemp Kelley, Adult and Gerontological Nurs- ing, 488 NB, The University of Iowa, Iowa City, Iowa 52242-1121 USA Phone (319) 335-7125; FAX (319) 335-7129; E-mail: lisa-kelley@uiowa.edu
