negotiating the dirty job of elder care in a north aegean islad

8/8/2019 Negotiating the Dirty Job of Elder Care in a North Aegean Islad

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MDSCH ANTPLG 22 (1) 2010 77

Why should I eat shit?

Negotiating the dirty work of taking care of elders

on an Aegean island

Giorgos kostaiotis

This article examines the ways that the informal, at-home care of frail elders is negoti-

ated in families living on a small Greek island in the Aegean. Local terms of reference for

various levels of care carry meanings of expectations for how family members, or even

outsiders, should be involved. Pivotal points in the decisions of younger family members

to provide hands-on-care for their parents and other elder relatives include a reconcili-

ation of obligations to return their economic, social and emotional support and take into

account cross-generational reciprocity in the form of property transactions. Meeting these

expectations accumulates social and symbolic capital and preserves the familys honour

and good name on the island. Middle-aged women are usually the ones who are called

upon to provide care and to protect the familys interests; consequently they are continu-ally balancing the care of elders and of children.

[elderly care, ageing, family relations, ethnography, reciprocity, social capital, Greece]

The support and care of elders usuall comes from three main sources: the state, thecommunit and the famil (Dohert 1985; ngland 2005; Lita 1985; ward-Grifn& Marshall 2003). n Greece, the state proides health care and pensions hich coerthe population oer 65. Lo-end pensions hoeer, are barel sufcient for meeting

the basic needs of food, medication and housing for the elderl attempting to continueto lie in their on home. ffspring are expected to assist aging parents both eco-nomicall and phsicall, helping ith dail actiities such as accompaning them tothe doctor, shopping for them and being on-call in times of need. According to Greela, rst-degree relaties (e.g., siblings, offspring, parents and spouses) are obligedto attend to the needs of famil members ho are unable to tae care of themseles, aproposition hich has a ariet of interpretations.

The care of frail elders ho need close attendance is traditionall proided b thenearest famil, primaril daughters and daughters-in-la. This normatie obligationtheoreticall begins from members of the nuclear famil and extends to the indred, e.g.,


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78 MDSCH ANTPLG 22 (1) 2010

cousins, aunts and uncles. Alternatiel, this tas can be assigned to a hired caretaer,usuall a middle-aged oman ith practical experience, but little to no formal training.This solution began to attract attention in Greece during the 1990s, hen masses ofimmigrants from Central and astern urope arried in the countr, proiding a cheaporforce in a clandestine econom (cf. van der Geest et al. 2004). For man Greefamilies toda, it is a gien that the care of an elder relatie ill inole paing outsidersto attend to dail care in the home (as ell as in hospitals). Sending an elder to a nursinghome is considered onl as a er last resort. lders resist being displaced from theirhomes, een though the ma encounter difculties and een dangers, and relatiesma accuse offspring ho leae a parent in a nursing home of abandoning the elder.Thus, the fate of elders is intimatel lined to that of their families. A large proportionof Greeces elderl lie in insecurit, a situation hich is much more common than it ispublicl admitted. when resources are limited and in are unable or unilling to pro-ide an help in times of need, an elders life ma end in agon and miser.

During three ears of anthropological eldor on vouni,1

a small Gree island inthe northern Aegean Sea, encountered numerous cases here the needs of a frail elderand the possible strategies of care became an arena of competing interpretations andnegotiations beteen the members of the nuclear and extended famil and indred.From 2004 to the present, hae been emploed as a local care manager for Help atHome, a national project for the elderl. For elders ho do not hae children or indredto isit them, the local Help at Home programme is their main life line their hope ofsomebod opening our door Consequentl, in the course of routine home-care isitsand conersations ith elders and their families, hae been alloed to itness andparticipate in otherise guarded and eiled facets of famil relations. Discussions ith

inhabitants of all ages in vouni indicate that the domestic care of elders is mediated bthe local sstem of economic, social, smbolic and emotional exchanges. The negoti-ation of these dimensions in proiding care for elders is the focus of this article hichill attempt to explore material (e.g., inheritance) as ell as emotional obligations andreciprocities. The notion of capital in its arious theoretical guises (social, smbolic,emotional) as a piotal point in human relations is also explored.

Households, inheritance and informal social insurance for elders

Transfers of ealth from the older to the ounger generation sere a number of goals to sho loe and affection, as a declaration of dut, support of the ounger generation(Finch 1989), a means of securing care in old age (Hetler 1990). nheritance practicesare assisted b and imbedded in inship sstems, residence patterns, marriage expec-tations and edding dories.

Property transfers and reciprocity

The inship sstem and residence expectations folloing marriage on vouni are similarto hat is reported in Gree ethnograph for other Aegean islands (Dimitriou-kotsoni


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1993; kalpourtzi 2001; vernier 2001). n contrast to the irilocentral and patrilocalresidence patterns of mainland Greece (Campbell 1964; Danforth 1979; Friedl 1962;vlahoutsiou 1997), in the Aegean islands, matrilocal or neolocal choices rule. Mostnel-married couples set up a home near the ifes famil, and matrifocalit isdemonstrated b an enduring strong mother-daughter bond (Casselberr & valaanes1976; Dubisch 1974; 1976; 1993; Papataxiarchis 1995). The marriage dor (proika)is the traditional institution for distributing parental and famil inheritance to bothdaughters and sons. The agreement, designated in a legal document, is part of mar-riage negotiations, but more recentl it has been replaced b a ill, apparentl toconform to famil la changes in the earl 1980s hich outlaed the dor. en so,vouniotes continue to gie a major part of their holdings to their children at the timeof the childrens marriage.

The major and most aluable portion of parental ealth is allocated to daughters inproiding a house for them at the time of engagement and/or marriage. Social norms

demand that a oung oman from een the poorest famil must be gien at least ahouse as a dor. Sometimes elderl parents manage to eep a small house and aitchen garden for themseles; hoeer, as one 80 ear-old man describes, n orderto gie a dor to their daughters, the parents need to leae their home, put the groominside and moe to a hut. As in man other insular regions of Greece, houses in vounitraditionall belong to omen (the deed is neer transferred to the husband) and func-tion as the centre of processing produce from the elds, preparing it for distribution,consumption and reposition of the surplus for future needs (Dubisch 1993). For thevouniotes, the house is also a poerful smbol hich attests to the success of the pro-ductiit and reproductiit of the famil through the generations and the place here

crucial decisions about the famils future plans are discussed and decided.Good marriages for their children ensures parents of assistance and a helpinghand in future times of hardship and hen it comes to the care of the elderl, thehelping hand is usuall female. Families ithout daughters often proide one of thesons ith a house so that he could bring in a daughter for his parents, perhaps aoung oman from a poor famil ith seeral other daughters (i.e., ith no dor ofher on) or an orphan (common during and folloing seeral generations of ar inGreece). Childless couples ma adopt a oung girl from the in netor, preferabla daughter from the ifes famil, initiall to assist ith the needs of the household,and later, ith those of old age. Most of these adoptions are not legall registered but

inole the same set of rights and obligations as in a biological parent-child situation,including proiding a legall secured dor as ell as expectations of care for agingadopted parents. n the past, these strategies assured that parents ould be taen careof in their old age b daughters biological, b marriage, adopted ho lied nearband ere all obligated to return the faours the receied.

From the 1950s to the 1990s, demographic, economic and social changes in Greeceplaced this familial and informal sstem of old-age insurance under considerablestress. ut-migration and depopulation of rural areas, an increase in the age of mar-riage and a decrease in number of children combined to create the present situationhere helping hands for elders are becoming increasingl difcult to nd. The crea-


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tion of a national health care sstem hich extends to the proinces and peripheralareas of Greece, along ith the improement of the standard of liing has led to anincrease in life expectanc. The proportion of elders among the general population hasincreased dramaticall (National Statistical Serice of Greece 2001), but their generalhealth condition has declined. n the 1950s, the life expectanc of a person connedto bed due to a serious health problem (e.g., stroe, heart attac, hip-bone fracture) orsimpl because of old age ould be a fe months at best. Toda, ith modern bio-medical technolog and improement in hgienic assistance, elders ith these healthproblems can lie for seeral ears. mplementation of biomedical technolog led notonl to an increase of the number of frail elders among the general population, butalso to an increased burden on caregiers from the famil.

National-leel socioeconomic and demographic changes hae reached the islandof vouni and hae affected the experience and expectations of groing old and theburden old age entails for both elders and their relaties. The majorit of caregi-

ers taled ith in vouni agree that taing care of a failing famil member can bedestructie for the caregiers health and ell-being, a consequence hich is sup-ported in the scientic literature (e.g. vrabec 1997). Hoeer, the social matrix of asmall communit intercedes to negotiate care of elders b reling on old traditionsand ne methods of presering the honour and good name of the famil, and creatingeconomic and social capital.

Family reputation as capital in Vouni

n a small island communit of less than 2500 inhabitants, economic and social

surial is dependent on the exploitation of all forms of capital aailable ithin alimited geographic and communal space. Dail interaction ith others in the com-munit requires constant attention to the maintenance of contacts ith relaties anda netor hich often extend to economic and nancial matters as ell (Hionidou2004; kalpourtzi 2001: 55-56; Salamone 1987; vernier 2001). Most vouniotes spenda great amount of time, energ and thought on maintaining and expanding social capi-tal hich the rel on for a ide arra of matters. The balance an on-going set ofreciprocal economic exchanges, obligations and faours hich range from lendingmone, offering a job, acting as a go-beteen for others (e.g., presenting a relatie toa local council member) to exchanging isits and gifts. en the act of shopping at

a particular store or exchanging a dail greeting or a friendl hello ma be imbuedith dimensions of broering social capital.

ndiidual and famil smbolic capital, the most signicant form of capital accord-ing to Bourdieu (1977), is formed b the public elaboration of personal stories throughgossip. As the people of vouni sa, reputation can open or close a door, an expres-sion applicable to a business agreement, a successful marriage, a helping hand indifcult times, or the authorit to promote a claim to a ide audience. Building andmaintaining a good name requires balancing actions to stand up to the expectationsof a ariet of audiences. Strategies of accumulation and maintenance of smboliccapital must be carefull orchestrated because eer act can be loaded ith ambigu-


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it. n small local settings it is er common that someone ill nd the opportunit tomae negatie interpretations about the acts of others or een begin gossip based onrigorous exaggeration. As the residents of vouni sa, A good name is hard to maeand eas to spoil.

The matrix of obligations from the interactions to create social and smbolic capi-tal can be isualized as a map here past protocols and results function as referencepoints for the expected outcome of similar exchanges in the present (Appadurai 1987).The good name of the famil is based on the honour of its men, the chaste behaiourof its omen and the reliabilit of its promises (Campbell 1964; Friedl 1962; Gilmore1982; Peristian 1966; Pitt-iers 1977). n vouni, these alues are challenged b thefamils abilit to impose, inuence or control poer and economic relations in thelocal setting. Thus, the issue of a good name is subject to change and ux. Hoeer,hat has not changed is the ethical obligation to care for famil members and the cen-tral place of omen as the primar nurturers and caregiers in the home and for the

famil. women pla a crucial role both as representing the inside of the famil to theoutsiders as ell as maintaining its internal harmon through their control of forcesof disorder and pollution (Dubisch 1986; 1993). en in preious generations, herethe ere expected to be auxiliaries to men, the ere also appreciated for their sillin nancial management, noledge of communit economics as ell as the moralguidance of other famil (Salios-othschild 1976; Salamone 1987). As men in vounisa, A ife can x or destro her husband.

The good famil name is both the inheritance and the heritage of the offspring(Sutton 1997: 431), ho ill eentuall fall heir to taing care of the elders. Familmembers are expected to be united in order to achiee the goals of the famil and meet

the needs of indiidual famil members. when ased locals hat constitutes a goodfamil, ould hear the immediate and emphatic repl, well, ll gie an example.Ourfamil is a good one! People ma describe other families as strong, capable orealth but it is their on famil hich is the paradigm.

Care in the family as presented to an outsider

when specic famil members are assisted throughout life b their parents, siblingsand other in, the are considered ethicall obligated to return the care. ndeed, thea that the obligation is handled has consequences for the good name of the indi-

idual and the famil, as supported in the folloing obserations about ho leni andDimitra manage to proide 24-hour dail care for their aging and incapacitated mother.

Dimitra had lied in a nearb neighbourhood on the island of vouni for most of herlife. leni ored in Athens here she lied ith her husband and daughter. A thirdsister ored in Athens and, unable to be present on the island due to other obliga-tions, contributed to the care b sending mone. She also used her leae-time fromor to assist her sisters ith hands-on care for their mother. During m isits to theirhome, both before and after their mothers death, as impressed b the fact thateer interaction beteen the sisters, at least hen as present, as conducted sogentl in spite of the stressful situation. leni explained to me in a priate discussion


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ith me that her mother alas looed after us ith loe. am returning that loeto her no. m just giing bac hat too from her.

Propert arrangements ere neer mentioned and there as no place for me to asabout them in this context. For the local ethos, it ould be considered a meaninglessimprudence. what as interesting in this case, here obligations ere neer ques-tioned, is ho leni justies, indeed normalizes, the sacrices she has made for hermother b referring to the ethics of reciprocit ell acnoledged in vouni. As sheputs it, she simpl returns hat she as gien in the past. en though families malac economic and political poer to impose their goals, the fact that its members areall right and proper ith their smbolic and economic exchanges among themselesand ith others indicates to residents of vouni that it is a good famil. People hohae not been right ith their on people are diminished in social and smbolic capi-tal. Although quarrels are common in families, vouniotes ant to eep their familproblems concealed from outsiders.

n vouni, the onl situation loe is expected to be offered unconditionall is fromparents to their children. vouniotes sa that True loe comes not from ords, butfrom actions, meaning that apart from sentimental support and understanding, loeincludes offering assistance in soling practical and economic problems. Parents shotheir loe to their children b tring to ensure that the ill not lac for anthing,either materiall or emotionall. Acquiring landed propert for the sae of ones chil-dren attests to the ealth of the famil; it is foreer, tangible, isible to eeroneand an uncontested means of offering loe. t represents more than emotional support,presents or small gifts of mone. Loing a child is an obligation because it is parentsho bring children into the orld. t also represents fullling an obligation to the

indred and past generations: As their parents raised them, this is hat the must doith their on children. n the other hand, parents hae a right to their childrensloe, onl hen and if the hae proen themseles orth of it b being consistentto all of their ethical, emotional and economic obligations as a parent.

The concept of struggling for or ghting on behalf of is also used to describethe a that parents care for their children. Parents in vouni put all their efforts inproiding for their childrens emotional, economic and material ell-being senti-ments deepl entrenched in proiding dories and inheritance of propert hich alsocreate reciprocal obligations. These altruistic actions are counterbalanced b the pos-sibilit that parents ill need their childrens support in the future. The often express

concerns about ho ill loo after b them hen the are old and unable to tae careof themseles perhaps anticipating that the ill hae gien aa all their resourcesand ill no longer hae an leer to demand care.

Local categories for the practice of care

when residents of vouni discuss the tass of care for elders, the standard Gree termfor care [frontida] is rarel used. nstead, the local expressions differentiate beteenlight care (see Dressel & Clar 1990) and more demanding, intense care obligations.


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Small serices and errands, light domestic or, follo-up on health care needs, emo-tional support and simpl eeping compan ith the elder are designated b the erbsfor loo [koitazo] and see [vlepo]. lders are looed after or seen to; their off-spring eep an ee on them. t is mainl daughters ho are expected to eep an eeon their aging parents, but sons (and their ies) are also inoled. en hen rela-tions are er strained beteen aging parents and their children, routine isits mustbe made for the the ees of the people. Bourdieu ould describe this as a strateg ofprotecting smbolic capital against the efforts of opponents to diminish it.

For aging parents, these occasional isits are better than nothing at all, een thoughothers in the small communit ma question the true motiation; e.g., real concern,feelings of obligation, potential economic gain. Those ho hae children liingnearb are looed after on a more regular basis. lders express that the ideal ouldbe to lie close to one of their children but in a different house, preferabl herea daughter (or less preferabl a daughter-in-la) could isit them, loo after them,

clean, coo or bring lunch from her home, oersee their medication and eep themcompan. Problems arise hen the fragile balance of this potentiall ideal situation islost due to the deterioration of an elders phsical capabilities from a sudden illness ora gradual decline in phsical and mental capacities due to aging. The indred orrhether their elder(s), if left alone in their home, ill behae, if the ill complith the directions of their doctors, chec their blood pressure, tae their medicinesproperl and not harm themseles. lders ho are heail dependent on their familare considered b eerone, een themseles, to be a burden. when this happens, theroutine of eeping an ee on them no longer sufces to balance their needs ith theobligations to offspring, famil and indred. Someone must begin to or on behalf

of or struggle for the elder.The erb hich is used in vouni to cone the concept of or and struggle[polemo] is the same one used to refer to ght or battle; as a noun, it means ar.ndeed, the vouniotes beliee that or has all the characteristics of a struggle forsurial, much lie ghting in a ar battle. The hardships of liing on a small islandith limited resources often lead to seere and prolonged antagonisms beteen resi-dents. The doxa2 of the inhabitants, their unquestioned, uncontested as of thiningand acting are probabl shaped b the ght to surie. Struggling on the behalf of anaging parent is an inestment; it brings claims, a tpe of interest in Bourdieus terms(1977: 39-40). t ma bring a monetar reard, or the satisfaction of or completed,

or the expectation of future benets. Hoeer, in the process, the elderl becometransformed from agents (doing their on or, cleaning the house, tending the gar-den, etc.) to objects. No longer able to or for themseles, the become the objectsof the or of others. This is exactl the tpe of situation abhorred b all elders invouni. The declare that the ould rather die than become a burden on their famil.

The boundar beteen eeping an ee on and struggling for is cloud; both con-cepts contain colliding interpretations and negotiations. Hoeer, there are non-nego-tiable eents hich indicate hen the needs of an elder can no longer be managed boccasional isits and the care leel needs to moe into the next phase of struggling for.warning signs include lapses in remembering the a to the itchen or bathroom, dif-


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culties in getting out of bed, forgetting personal hgiene, and the most smbolicalland practicall loaded matter of personal toileting. The period beteen the momenthen the problem is communicated and the moment that a sustainable arrangementis reached is full of stress and anxiet for all inoled. t is time for the oungerfamil members to meet their obligations of care for a frail elder and to capitalizeon the alue of fullling promises and parental expectations. t is also the time forlast-minute alliances, confessions and the solidication of erbal contracts or rittendocuments of commitment regarding nances and inheritance.

The accidents from incontinence challenge eer caregier and become a night-mare for famil members ho personall attend to their elder(s), and an een greatertrauma for elders. The fear of not being able to control priate bodil functions appearsin deepl entrenched Gree expressions about urinating or defecating on ones self outof fright [katouriemai/hezomai pano mou], maing a big mistae or maing a messout of things ( made shit out of eerthing!), expressing contempt (Let him shit

on himself!) or placing a curse (at shit!). Decisions about ho undertaes thedirt or in caring for incontinent elders are made according to past agreements,ofcial or unofcial, regarding the distribution of parental holdings. t is an unspoenunderstanding in vouni that the person ho undertaes ghting on behalf of an elder(and taing on the dirt or) is alread indebted b a prior propert transfer, usu-all a dor. Thus, daughters are rst in line to commit to the struggle. f there are nodaughters aailable daughters-in-la are also candidates for the struggle; een thoughtheir on dories come from their on parents, the hae obligations to support theirhusbands inheritance.

lders ma offer hidden assets in exchange for protection and intimate bodil care;

for example, a piece of land that up to that moment as promised on ord to anotherfamil member. Those ho do not beliee the receie the at-home care the need masuddenl decide to leae their last belongings to the church. n the one hand, the mause this tactic in a genuine effort to bpass the aiting list for the churchs nursinghome; on the other (probabl more liel), the use this as a method to mobilize rela-ties to tae action b proiding more and better at-home care. Sometimes it is onl anelders ultimate surial strateg, but for elders that hae lied all their life at the bottomline of smbolic and economic hierarchies, een this last deice ma proe useless.

The folloing case stud is an extreme example of the as the famil relations,and the socio-economic status ma prescribe the last das of a vounioti elder.

Without a family: Calliope and Panayiota

Calliopi neer married nor had children. She reached old age ithout an signicanthealth problems, an asset hich alloed her to lie on her on in her small one-roomhouse. when she as 82 ears old, she fractured her hip in an accident and requiredsurger. She neer full recoered from the fall and became unable to al or get outof bed. No one had eer lied Calliope, perhaps because she had been diagnosed asmentall ill, and she as treated b eerone as an outcast. She as ithout an nan-


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cial resources and eerone in the area ne that she ould be unable to pa anoneto tae care of her. No one felt obligated to her or illing to struggle for her either formonetar contributions or hands-on care.

when the situation became increasingl difcult, Panaiota the ife of one ofCalliopis nephes as called upon to tae care of her. Panaiotas extended familon her husbands side implied that she should tae care of Calliope because she liednext door. She stated that she felt suffocated b the expectations of the relaties thatshe should be the one to undertae the dirt job of cleaning and toileting Calliopeand she rebelled: we neer ere close ana. wh should be eating her shit no? dont oe this to anone.

As time passed, in spite of her negatie feelings, Panaiota ended up giing Cal-liope some help, in particular in feeding her and administering her prescribed medita-tion. For this she gained considerable smbolic capital as a good and merciful oman.No one eer shoed interest in undertaing bathing and diapering tass, or in con-

tributing nanciall to hiring a professional to attend to these matters. Nobod founda reason to do so, nanciall or emotionall. All the dirt or as conducted bthe personnel of the local Help at Home programme, until, after a long struggle ithpaperor, petitions and negotiations, a local social orer managed to nd a phil-anthropic place in a nursing home run b the rthodox Church in the port ton. Thisas almost three months after the initial incident hich caused the Calliopes impair-ment. She died a fe ees after her arrial at the home.

The same coprophagic metaphors seemed to be alas present in all of localsconersations about Calliope. t seemed that suddenl her faeces had become an issueof public debate. Men and omen ould een stop me on the street asing if she as

earing diapers and ho often the ere changed, if she as smell, ho she asbathed, and so on. entuall people ould sa to me So, nall ou hae ended upeating her shit, referring to the Help at Home personnel ith smpath. en a priestexpressed his reserations about the odds of Calliopis b-passing the aiting list ofthe churchs nursing home: wh ould the do that? Just to eat her shit? The reasonCalliope as not onl left to her on fate but also unprotected against public ili-cation can be seen as a result of her inabilit to create social capital amongst peopleobligated to her at an leel. Additionall, she had no considerable economic capitalsuch as a house and her smbolic capital as so small that she could not expect beingrespected b anone.

These comments are extraordinar in a culture here the bodil uids of others areconsidered extremel disgusting, if not rituall polluting. The local erbal etiquettecalls for adding excuse me to an uttering ords or phrases such as toilet, urine,underear, etc. en so, as mentioned earlier, coprophagic metaphors are frequentlused to emphasize mistaes, sho contempt or express a curse. There ere seeralother cases before Calliopes hen the health aides from Help at Home needed toattend to dirt or, but there as neer so much fuss about it. Besides, especiallfor omen, ho in Greece are primaril responsible for the material and smbolicpurit of the household (Salamone 1987) cleaning up faeces of both babies and eldersis a triialit of life ell concealed behind house alls. t ould be unthinable for a


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mother in vouni to complain about diapering her children, much less to use a coprap-hagic expression to refer to this care. n the case of a frail elder, hoeer, ariousscatological thoughts might pass through a persons mind, but the ould rarel bestated in public. Panaiota as not eeping an ee on Calliopi because she loed her;indeed, relationship had alas been bad. ather, as she said, she helped because sheas feeling pit for her. For the public ee this as a sign of mercifulness. She asabundantl praised for hat she did for Calliopi. Merc can be offered to anone; itcan be seen as giing ithout expecting a return (Sahlins 1972).

Care giing ithin the famil has often been sanctied in the care ethics literatureas an arena encased in moral and ethical alues that goern behaiour, inuenced ba long tradition in western thought hich runs from Heidegger to Maeroff (1971)and Tronto (1993).

Those ho sincerel care for others act for particular others and for the actual relation-

ship beteen them, not for their on indiidual interests and not out of dut to a uni-ersal la for all rational beings, or for the greatest benet of the greatest number (Held2002: 166).

while the concept of reciprocit is coherent and useful in the maret econom, itcould easil be argued that it is out of place and incompatible ith the ethics andmoralit of genuine care. Hoeer, the parameters of generalized reciprocit asoutlined b Sahlins (1972), offer resolution. n contrast to balanced and negatie reci-procit here obligations are based in chronological and quantied measures, generalreciprocit does not carr rules about the time, the qualit and the quantit for the

retribution of the obligation. eciprocit in caregiing has these exible qualities and,thus, resembles the mentalit of gift-exchange reciprocit hen the mutualit of thegift is concealed b the chronological dela in the return (Bourdieu 1977; Carrier1991; Malinosi 1983; Mauss 1989).

Social norms about hat comprises good caring in different social settings arealas contested in practice b conicting notions of needs and responsibilities andshortage of economic and social resources (Badini-kinda 2005; Finch & Mason 1993;isseeu 2001; van der Geest 2002; vera-Sanso 2004: 79). Famil solidarit in vouniis also based upon such a scheme of reciprocal exchanges. The main question thatarises is ho the nature of the exchange is understood and treated b the e partici-

pants (Finch & Mason 1993: 57). As the next case shos, notions of moralit regardingelder care in vouni arise in relation to past famil transactions in the form of dor, theobligation of pabac and the commitment of parents to help their children. Tensionsemerge hen decisions faouring one famil member oer another are made.

Reminder of an obligation Maria, Georgia and Anna

Maria is an elderl ido ith a small pension and non to vouniotes for her ca-pacit to stir up relations beteen people. Anna and Georgia, Marias onl children,


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hae been liing in Northern urope for seeral ears. Anna and her husband built ahouse in the islands port ton. Georgia as not so fortunate and has serious healthproblems. Perhaps this as the reason Maria gae Georgia her home een if it is ina little isolated illage house heated b a ood-burning stoe and ith toilet facilitiesoutside of the house. Gossip sas that Anna as not consulted in the decision.

Anna suggested to her mother that she could lie in the ne house built b herselfand her husband. The house as a considerable improement from Marias on il-lage house, hich she had alread bequeathed to Georgia. Anna offered the house toMaria rent-free, a generous offer as she could rent the house to strangers hich asa usual practice for islanders liing abroad. After some ears, Annas son, kostas,formerl liing abroad, came to lie in the house in the ton, a situation hich causeda great deal of tension beteen the oung man and his grandmother. ver soon, theto ere not speaing. n kostas ie, Maria tried to undermine his relations ithAnna, using false and unjust accusations. He considered the possibilit of leaing and

renting a room elsehere. Suddenl, Maria had a stroe, leaing the loer part of herbod paralzed. Her daughters immediatel returned to vouni from abroad, but it soonbecame apparent that one of the to ould assume the long-term care.

Georgia as the liel candidate as the social custom suggests that the personho inherits the maternal house is responsible for the care of the elders ho formerllied in it. But the illage house as not compatible for the needs of a frail elder, thusGeorgia needed to relocate to the house in ton here both she and her mother ouldhae to mae do ith Marias small pension. Georgia oices her concerns during aHelp at Home isit; e.g., she has her on health problems, lacs mone, the illagehouse lacs facilities for the care of her mother. eminding Anna that She is our

mother, too, Georgia claims that Anna should contribute to their mothers care bdoing some of the or herself or giing mone or alloing both Maria and Georgiato lie in the house in ton.

None of these options is acceptable to Anna. She has to eigh the cost to her son,kostas ho is alread stressed b the tension ith his grandmother and if bothMaria and Georgia ill sta in the ton house, he ill hae to rent somehere else.Anna also sas she cannot leae her life, her or and moe to vouni for the sae oftheir mother and she is not able to contribute mone. t is Georgias job to or forMaria and both of them should moe to the illage house, in spite of its difculties andlac of modern coneniences. She suggests that if Georgia cannot go through ith this

plan, their mother should be put to a local nursing home.Georgia replies. ont thro m mother aa. Anna ansers in the same tone,

The a ou to arranged things, no do hat ou ma. you made our bed, nosleep in it. Her statement implies that Georgia and Maria had a secret arrangement,including naming Georgia as the oner of the illage house in Marias legal docu-ments for her ill.

within to das Georgia and Maria moed to the illage house. The entire situa-tion created a great deal of comment from the local population. There ere to focalpoints sometimes used in arguments put forth b the same person, an indication ofthe complexit of the inestments. The one as that Anna as undul cruel, because


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ou cannot thro out our parent lie this. The other, that she as not obliged todo otherise: ts Annas job to manage the needs of her son ith those of theirmother: who should she loo after, her mother, or her son? The issue of Mariasreputation to stir-up people and situations as also brought in: Dont imagine thatshe is blameless. n the meantime, Georgia gained smbolic capital from the locals;she as praised b eerone for undertaing the burden and doing hat she had todo and for meeting her obligation as the heiress of the maternal propert.

Annas strateg of forcing eerone to mae his on choices as er effectiein terms of the local alue sstem. She pushed her sister to do the right thing andto set aside her on difculties. She also protected the interests of her on nuclearfamil particularl those of her son to care for him is a number one obligation ofa good mother. She rised her on and her famils smbolic capital b sendingher mother bac to the little illage house and inited future comments of well, oureap hat ou so and might be iced out of her on sons home in her on old

age. Hoeer, she consolidated her claims to receiing proper care from him in laterears. Her son, according to the local ethics of exchange, became obligated to returnthe faour to his mother.

In closing

A quic reie of the relationship beteen the informal social insurance sstem asit functions for the care of elders in vouni intertines inheritance practices, inshipobligations, residence patterns, marriage expectations and edding dories. Threads

of affection and concern, loe and mabe een fear, run through these traditions andthe local doxa. Decisions oer the distribution of assets ma faour one child oeranother and cause seere famil conict (Titus, osenblatt & Anderson 1979) hichcan prooe tremendous complications in taing care of elders. For elder vouniotes,eeping all their children happ and at peace ith each other through a just sharingis a strateg that gies a better chance for a safe old age. This lifelong strateg is easierto achiee for the more prosperous.

The dut of offspring, particularl daughters, to attend to the needs of aging parentsis conceptualized as the repament of long-standing debt to them. ts most unchal-lengeable proof of its existence in the public ee is the transfer of parental propert

to offspring or if there are none, to another relatie hich automaticall implicatesthem in the chain of pabac hen the time comes. The particular form of pamentis publicl scrutinized and controlled through mechanisms of social sanction such asgossip. Leels of care are designated, not as care per se, but b expressions hichrefer to looing after or seeing to and, hen hea-dut care becomes required,b ghting for or struggling on behalf of. The leel of indebtedness (hich can beemotional as ell as material or economic) proides the context for both the tpe ofcare to be implemented and the particular famil member(s) selected to carr it out.

n recent ears, perhaps beginning a generation ago, this social insurance schemehas become increasingl ulnerable to snags, strains and een failure. The groth of


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the aging population places increasing expectations on famil members as caregi-ers. Middle-aged omen, and especiall mothers are caught in the middle of togenerations that need their help; their children and their parents. The struggle toproe themseles orth of their elder parents b caring for them properl and assist-ing their on children. This is not unique to vouni; in most societies throughout theorld, omen are called upon to be the caregiers, either informall in the famil orin the ofcial care sstem (nurses, health aides, medical social orers, etc.). womenare considered to be the natural caregiers of choice due to their adeptness to cul-tiate ties of personal affection and their capacit to express empath, elicit mutualtrust (Held 2002: 166). t is not b chance that care ethicists derie paradigms fromthe experience of omen in actiities of care particularl for children, the ill and theelderl (Gilligan 1982; Noddings 1986; uddic 1989).

Notes

Giorgos kostaiotis receied his Masters Degree from the Department of Social Anthropol-og & Histor, niersit of the Aegean, in 2008 for the thesis: Thank God we still stand onour feet: Bodily capital, property transactions and obligation about elder care in an Aegean

island. Currentl he is conducting eldor for his PhD dissertation entitledBody and politicsof care: Bodily, symbolic and emotional capital in the Greek family and society on the island

of Vouni here he ors as the coordinator of the local national Help at Home programme.-mail: [email protected]

ould lie to than winn koster, Janus omen and other participants of the Care & HealthCare Smposium held at the niersit of Amsterdam, December 2009, for their constructie

comments. This or ould hae neer been possible ithout the encouragement and help ofDeanna Traas, hom most deepl than.

1 vouni is a pseudonm, as are all the names of people and places in this article. The selectionof the toponm is inspired b the rugged panorama of the island and is deried from theGree ord for mountain [vouno].

2 The term doxais used to denote hat is taen for granted in an particular societ andhat its members share as basic assumptions about realit and the a the orld ors.n this ie, doxa is the experience b hich the natural and social orld appears as self-eident, the unierse of the undiscussed (Bourdieu 1977: 168).

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