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Language and aging: written autobiographical practices with elderly

ABSTRACT:

The population is aging at an accelerated rate around the world, and Brazil has been following this global trend. Brazilian public policies recognize that the growth in human longevity generates a series of demands for the entire population to age with quality of life and autonomy. This study aims to analyze the effects of written autobiographical practices developed by elderly subjects in generating individual autonomy and well-being. The study included five women and three men, between 60 and 87 years of age. This is a case report, with qualitatively analyzed data. The body of analysis consists of fragments of answers recurrently given by the research subjects in a semi-structured interview. This interview focused on questions about the activities of reading and writing developed by the subjects before and after they participated in meaningful practice with the language. From the analysis of the responses provided, it is possible to say that autobiographical writing can constitute an effective literacy practice, able to provide well-being, self-esteem, personal fulfillment, immortalization of experiences and personal stories, memories, and redemption of promoting attitudes of citizenship. Thus, this case study indicates that speech therapy focused on the increase of literacy practices with the elderly can meet the principles and proposals of healthy public policies geared towards the aging population, promoting autonomy and active participation of older people in the community, as well as increasing their chances of experiencing a healthy and successful aging process.

KEYWORDS:
Language; Aging; Health of the Elderly; Speech, Language and Hearing Sciences

RESUMO:

O envelhecimento populacional está ocorrendo de forma acelerada em todo o mundo e o Brasil vem acompanhando essa tendência mundial. As políticas públicas brasileiras reconhecem que o crescimento da longevidade humana gera uma série de demandas para que seja oportunizado a toda população um envelhecimento com qualidade de vida e autonomia. A presente pesquisa objetiva analisar os efeitos que práticas de escrita autobiográfica desenvolvidas por sujeitos idosos podem gerar em sua autonomia e bem-estar. Participaram deste estudo cinco mulheres e três homens, com idades entre 60 e 87 anos. Trata-se de um relato de caso, cujos dados são analisados qualitativamente a partir da Análise do Conteúdo. O corpus de análise é composto por respostas elaboradas pelos sujeitos da pesquisa a uma entrevista semiestruturada. Tal entrevista, focou-se em questões sobre as atividades de leitura e de escrita desenvolvidas pelos sujeitos antes e depois de terem participado de práticas significativas com a linguagem. A partir da análise das respostas, é possível afirmar que a escrita autobiográfica pode constituir-se numa prática efetiva de letramento, capaz de proporcionar bem-estar, autoestima, realização pessoal, imortalização de experiências e relatos pessoais, resgate de lembranças e promoção de atitudes de cidadania. Esse estudo de caso indica que um trabalho fonoaudiológico voltado ao incremento de práticas de letramento junto a pessoas idosas atende a princípios e propostas das políticas públicas saudáveis voltadas à população que envelhece, pois promove autonomia e participação dos idosos na comunidade, ampliando suas possibilidades de vivenciar um envelhecimento saudável e bem-sucedido.

DESCRITORES:
Linguagem; Envelhecimento; Saúde do Idoso; Fonoaudiologia

Introduction

The growth of population longevity is a fact that is advancing around the world11. World Health Organization (WHO). World Health Statistics; progress on the health-related millennium development goals (MDGs). 2009. [Acesso em 20 dez. de 2012]. Disponível em URL: http://www.who.int/whosis/whostat/2009/en/index.html.
http://www.who.int/whosis/whostat/2009/e...
, and unevenly, throughout Brazil22. Veras R. Envelhecimento populacional contemporâneo: demandas, desafios e inovações. Rev Saude Pública. 2009;43(3):548-54.),(33. Araújo, LF, Coelho CG, de Mendonça ET, Vaz AVM, Siqueira-Batista R, Cotta RMM. Evidências da contribuição dos programas de assistência ao idoso na promoção do envelhecimento saudável no Brasil. Rev Panam Salud Publica. 2011;30(1):80-6.. Given such growth, the United Nations adopted the International Plan of Action on Aging44. Organização Mundial Da Saúde. Envelhecimento Ativo: uma política de saúde. Contribuição da Organização Mundial da Saúde para o segundo encontro mundial sobre envelhecimento, realizada em Madrid, 2002. Tradução realizada pela Organização Pan-Americana de Saúde, Brasília, 2005., which points out that governments around the world must face an aging population, while promoting political change in all sectors of society, in order to realize the potential of older people in the 21st century. To account for this proposal, the Brazilian government enacted laws such as the National Elderly Policy55. Brasil. Presidência da República. Subchefia para Assuntos Jurídicos. Decreto n.1.948, de 3 de julho de 1996. Política Nacional do Idoso. Disponível em: http://www.planalto.gov.br/CCIVIL/decreto/D1948.htm. Acesso em: 11 dez. 2011.
http://www.planalto.gov.br/CCIVIL/decret...
, the Elderly Statute66. Brasil. Presidência da República. Subchefia para Assuntos Jurídicos. Lei nº 10741, de 1º. de outubro de 2003. Estatuto do Idoso. Disponível em: http://www.planalto.gov.br/ccivil_03/LEIS/2003/L10.741.htm. Acesso em: 11 dez. 2011.
http://www.planalto.gov.br/ccivil_03/LEI...
and the National Policy on Elderly Health77. Brasil. Ministério da Saúde. Portaria nº. 2.528,19 de outubro de 2006. Política Nacional de Saúde da Pessoa Idosa. Disponível em: http://www.ciape.org.br/PolíticaPIdosa2528.pdf. Acesso em: 11 dez. 2011.
http://www.ciape.org.br/PolíticaPIdosa25...
, from which health professionals consider quality of life and autonomy in an elderly patient's overall health and longevity.

From this perspective, speech therapy can contribute primarily to the promotion of health and citizenship in the elderly, restoring the role of language as a constitutive activity with the subject's social reality. Therefore, the fundamental property of language is the constitution of people in all cycles of life88. Gamburgo LJL, Monteiro MIB. Singularidades do envelhecimento: reflexões com base em conversas com um idoso institucionalizado. Interface: Comunicação, Saúde, Educação. 2009;13(28):31-41.. Studies indicate that social interaction and access to education and health depend essentially on interlocutory processes that take place in language99. Souza FPP, Massi G. A influência da estrutura de um grupo na linguagem escrita de idosos: um estudo de caso. Rev Soc Bras Fonoaudiol. 2011;16(3):350-5..

Thus, reading and writing abilities, as experienced by the subjects, are crucial in their aging process, especially when considering the fact that the current global society is "graphocentric," i.e., based on written activities1010. Torquato R, Massi G, Santana AP. Práticas de letramento no processo de envelhecimento. Envelhecimento e letramento: a leitura e a escrita na perspectiva de pessoas com mais de 60 anos de idade. Psicologia: Reflexão e Crítica. 2011;24(1):89-98.),(1111. Rojo RHR. Letramentos escolares: coletâneas de textos nos livros didáticos de Língua Portuguesa. Perspectiva. 2010;28(2):433-65.. In Brazil, literacy is widespread but unevenly distributed. For although 94% of the Brazilian population has become literate, only 26% of the population has reached the full level of literacy, making meaningful use of reading and writing in various social activities. And among older Brazilians, there is persistence in the proportion of illiteracy and the inability to use reading and writing functionally1212. INAF: Índice de Alfabetismo Funcional. Instituto Paulo Montenegro acessado pelo link: www.ipm.org.br/ipmb_pagina.php?mpg=4.02.00.00.00&ver=por.
http://www.ipm.org.br/ipmb_pagina.php?mp...
.

Low levels of literacy in seniors also occur in other countries. A study conducted in the United States, with more than two thousand five hundred elderly subjects, points out that the literacy level of the elderly population in the country is directly associated with low socioeconomic status and lack of access to public health by the surveyed population1313. Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S et al. Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc. 2006;54(5):770-6..

Another study1414. Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. (2007). Health Literacy and Mortality Among Elderly Persons. Arch Intern Med. 2007;167:1503-9. investigated more than three thousand American patients over 65 who were under medical care and found that when patients cannot read, they find it difficult to take medication properly and do not develop attitudes necessary to keep themselves healthy, concluding that elderly patients who are unable to read are 50% more likely to die from heart disease than those who can read.

On this issue, the importance of literacy on health should be emphasized. It refers to the ability of people to understand aspects of self-care, and their ability to take advantage of actions in the field of health education. Recent research indicates that the impact of social inequality on Brazilians' health can be aggravated by illiteracy, which has been observed in greater proportion in groups consisting of low-income and less-educated elderly subjects1515. Santos ML, Paixão RL, Osorio-de-Castro CGS. Avaliação da alfabetização em saúde do sujeito de pesquisa. Rev. Redbioética/UNESCO. 2013;1(7):84-95.),(1616. Paskulin LMG, Bierhals CCBK, Valer DB, Aires M, Guimarães NV, Brocker AR et al. Alfabetização em saúde de pessoas idosas na atenção básica. Acta Paul Enferm. 2012;25(Número Especial 1):129-35..

This data points to the urgency of implementing public policies to ensure the promotion of literacy practices among the elderly. In this sense, this research aims to analyze, from a literacy perspective, the effects of autobiographical writing practices in generating autonomy and well-being in elderly subjects.

Case report

This study was approved by the Research Ethics Committee at the University of Tuiuti (UTP), under register number 102/2008; subjects signed a consent form. The names of the subjects presented in this article are fictitious in order to protect their identities.

The study group was composed of eight elderly subjects who took part in weekly meetings proposed for the completion of a Language Workshop held at a Standard Health Unit (SHU) in the city of Curitiba, the capital of the state of Paraná.

Among the proposals developed in the SHU, was the Language Workshop, aiming to promote literacy among seniors, which is organized as follows: for four months, reading excerpts are used to trigger discussions and dialogues among its participants. These texts are from different genres (lyrics, poems, essays, reports) and covering topics such as old age, family, the labor market, and spirituality, among others.

After reading and discussing the excerpts, the activities of the workshop next focus on increasing oral narratives about significant moments and milestones in the lives of the elderly participants. These narratives are written down and then rewritten by the participants into autobiographical texts over a period of four months.

This activity was developed with the understanding that most elderly participants state that they are not able to write their life stories. They say they do not read well and do not know how to write. They claim to have low levels of education and that writing is something for people with a higher level of schooling.

In 2007, a speech-language therapist coordinator and nine seniors participated in the workshop. The meetings took place weekly, lasting an hour and a half each.

Of the nine seniors who attended the workshop in 2007, eight are included in this study, as one subject was not involved in the data collection due to the death of her husband. Of the eight subjects in the study, five were women and three were men, aged between 60 and 87 years. The monthly income of the subjects ranged from one to five minimum salaries per month. Survey participants had an average of six years of schooling and were retired or pensioners of the National Social Security Institute (INSS).

For data collection, individual oral interviews with the subjects were carried out after the subject write his/ her autobiography, and took place from February to March 2008 in the SHU. The semi-structured interview contained 20 questions, six of which dealt with the characterization of the subjects and 14 inquired about the way that the autobiographical writing was done for the elderly. Responses were recorded, transcribed and reviewed by the participants. The organization and the discussion of the results were based on a qualitative approach, according to Content Analysis, as proposed by Bardin1717. Bardin L. Análise de conteúdo. Tradução Luis Antero Reto; Augusto Pinheiro. Edição 70, São Paulo, 2011.. Thus, taking into account such a methodological basis, the development of analysis included the following five steps: assigning a fictitious name to research participants; transcribing answers given by the participants; thorough and exhaustive initial reading of the answers of the participants; categorizing these responses based on the purpose of the study; discussion of the data.

Results

The results were organized into four themes that emerged from the participants' answers: 1) the position taken by the elderly in relation their ability to read and write; 2) the role of the group in motivating the participant in writing; 3) relationship between better reading/ writing ability and greater social inclusion; 4) the role of autobiographical writing in the aging process.

In the first category of analysis - the ability of the elderly research participants to read and write - the participants produced the following oral statements from issues related to memories that they had from the reading and writing experiences developed throughout their lives.

Zulmira: In my childhood I could not write more, read more, because my father was a very simple man, he also did not study. He struggled. Also he taught himself to write. At home I could not pick up a book. I had to hide my reading.

Dilma: The thing that struck me is that I have not studied. No one ever told me I had to study to be somebody. When I wanted to read the newspaper, when I saw others reading, I felt like I was watching. I wanted to read, learn, speak, see. I just sign my name. I am ashamed to write, people laugh at me [...] I'm afraid for people to see what I wrote wrong and laugh at me. It makes me sad.

Ligia: I never studied much. I always tell the children, "study because it is important." Anyone who has not studied does not know much grammar and does not even know the verbs. Someone who studied knows grammar. I have the content but I lack the form [..] To be a writer, you need to have studied.

Regarding the second category of analysis, established around the role of the others in the group in facilitating literacy exchanges among the elderly participants, responses have been prepared on the basis of questions about the factors that motivated the writing of their life stories in the Language Workshop.

Zulmira: It's wonderful to have participated in this group. It's unforgettable to know that I can put a part of my life on record. [...] The group is a very strong incentive. I feel very strong help, which raises us up. We get stronger. A moral help.

Oscar: For me it was a surprise. [...] It was a very pleasant surprise. I came to the group because I was shy to talk to strangers. I thought that I would open up, expand my horizons, and lose my embarrassment to talk. I was surprised to learn that in addition to speaking, I would write a book. It was very surprising and an even greater joy when we completed the book. [...] The group made me move forward, progress, move forward in time and space.

Dilma: I had it saved inside me. I still have a lot of things stored inside. I could write books and books if I were to write everything. (...) I can speak and nobody is laughing. When I joined the group, it was there that I let myself go.

Valdete: I wanted to write but had never started. The incentive from outside made me get my dream from inside. From the group we created this desire to write. The group encourages, stimulates writing. The stimulus makes you feel a part of everyone, able and important, valued.

Ligia: I feel important with the book, dedication and commitment from all of you. Without this commitment this book would not be done. One day you will say that those who participated in this senior group at the SHU had the pleasure to learn from all of you.

As for the relationship established between better reading/ writing ability and greater social inclusion, corresponding to the third category of analysis, the answers given by the elderly subjects were developed from issues related to the group's contribution to their ability to read/ write and the impact of such contributions in their forms of social participation.

Zulmira: Writing this book and joining the group is a way to take care of myself, help me to be able to help others. [...] I think it's very important to have written these stories because it makes me feel good and it can help others. I hope to help others with what I write. I hope to pass on good things, important things for people to age better.

Oscar: Writing this book means I'm participating with others in their life stories. Living with each other was a great pleasure for us. Making such a book in this sense is good. Using our minds and participating in the subject to use as much of your memory as possible to make a good book that I will not regret later or think I should not have done.

Esther: It has helped develop reading. I am reading and writing more. Before I did not write as much as now. I want to write more about life. Pass on my mood, coexistence with others, friendships.

John: After writing, we were encouraged to do more things like reading and participation. We had something of a so-so life. We feel more comfortable sitting together, more encouraged to write. Everyone wants to do their part, show their knowledge with comfort.

Otto: Through writing we can learn, get acquainted with people from the past. Generations learn through writing. I have written more. Writing an autobiography changes a person, the person relates. People see us with more respect. Regarding myself, I feel worthy. Dignity is when a person looks at us with more respect. I am respecting myself and giving myself more value.

Ligia: I am on my way to the end of life. This was my only mindset for some time (writing the book). [...] Imagine one day my children, my grandchildren, look at a shelf and see that their grandmother, at 82, wrote about songs that impacted her childhood.

Finally, with regard to the role of autobiographical writing in the aging process, linked to the fourth category of analysis of this study, it should be clarified that the texts submitted in response were produced through the questions asked during the interview about the role that autobiographical writing had in their relationship to aging.

Oscar: It seems I started over, I was younger. [...] I was younger with the writing of this book, a clearer head in the way of thinking, acting, being more united, more friendly. Writing allows the young man who lived inside me come back to my memory now in old age.

John: I found it interesting that I remembered many things I've done and left undone. What I wrote, I can always remember.

Otto: The writing part of this exercise shows how to succeed in life. It was very meaningful to write. An example for the grandchildren to show that life is not just good times, there are difficult times too. It is very meaningful to write.

Valdete: It means a lot. Writing gives new meaning to old age. (...) Writing and being part of this group helps in old age. Just leave the house and go to the group, we're already coming out of our shells. Sometimes we withdraw at home with chores, and then an opportunity like this comes along.

Ligia: When did I ever imagine a day to be in a room surrounded by people signing a book? Sometimes I get the photos from that autograph night, I keep looking and do not believe it because I never thought it was possible to reach this time to have a moment so good, so satisfying. [...] Writing the autobiography is a good thing about old age.

The opinions of the elderly about their reading and writing abilities were reflected in a causal relationship between these abilities and their school experience. Statements showing that older people did not consider themselves qualified to read and write because of restrictions from their schooling processes recurred when they started their participation in the Language Workshop. The inability and difficulties in reading and writing were related to seniors who have little education and not to fluent in the formal aspects of language.

The fact that they refer to limitations in reading and writing, because of insufficient schooling, refers to meanings produced by the current social discourse. Such discourse is linked to the notion that the accumulation of formal study ensures the learning of grammatical aspects of the language and therefore the establishment of competent readers and writers, with high literacy1010. Torquato R, Massi G, Santana AP. Práticas de letramento no processo de envelhecimento. Envelhecimento e letramento: a leitura e a escrita na perspectiva de pessoas com mais de 60 anos de idade. Psicologia: Reflexão e Crítica. 2011;24(1):89-98..

However, it is important to analyze how the opinions of the elderly presented in these speeches was relativized after their participation in the workshop. If the subjects in this study initially said they were unable to read and write after reading various genres, then autobiographical writing production showed them to be capable. The vision of themselves as readers and writers, has changed. It was verified that this change occurred simultaneously with the redefinition of the concepts formulated by the elderly about what reading and writing is, before so focused on grammar, and then the possibility of the reading and writing of significant texts, being able to think about their life stories.

Discussion

The speech-language therapist's work in a language workshop, as presented in this study, was to direct reflections about the relationship of the subject with written language. The work focused on literacy activities and thus showed changes in their relationships with reading and writing activities. Before the study, such activities were taken as proof of their lack of formal education, the lack of spelling conventions, fear and shame in writing. Then they proceeded to take their own writing as a possibility of personal and social recognition, appreciation of history itself.

The relevance of the group component is recurrent in the answers of the seniors as it pertains to changing how they perceived themselves as readers and writers. If, before joining the Language Workshop they felt unqualified in their speech and writing, literacy practices developed during the meetings of the Workshop gave them new discursive situations, which increased their appreciation for speaking and relating their experiences. So from reading and writing activities, guided from a literacy perspective, seniors might perceive language as a way to organize their personal accounts and not just as an instrument to cause them embarrassment due to a so-called lack of spelling mastery.

Fragments of older texts show the decisive role that a job aimed at promoting literacy could play in the (re)constitution of their life stories through language99. Souza FPP, Massi G. A influência da estrutura de um grupo na linguagem escrita de idosos: um estudo de caso. Rev Soc Bras Fonoaudiol. 2011;16(3):350-5.. The answers provided by the elderly subjects indicate that significant practices of literacy, as in the autobiographical writing, led them to recognize themselves as the subjects of history, as citizens, indicating greater social participation and autonomy. After reading different genres and writing personal stories, the elderly started to value their life stories and their own old age, emphasizing writing as an activity able to immortalize them for generations to come. Writing their autobiographical accounts allowed them not only to recall memories of events and experiences from the past, but also to redefine those experiences88. Gamburgo LJL, Monteiro MIB. Singularidades do envelhecimento: reflexões com base em conversas com um idoso institucionalizado. Interface: Comunicação, Saúde, Educação. 2009;13(28):31-41..

It was possible to learn, from the responses of the elderly, about their desire to write and to be authors of their stories, not only as a way to upgrade memory, but also as a fundamental possibility of development in the aging processes experienced by them. So, let us state that the activity with written language gave them well-being, self-esteem, self-fulfillment, returning memories and social integration. From the recognition of the authorship of their personal accounts, the elderly in this study indicate that they can see themselves as social resources, allowing them to overcome stereotypes that label seniors as a socio-economic problem.

They show that the autobiographical writing was presented as an alternative in achieving gains that Brazilian and international legal provisions seek to provide44. Organização Mundial Da Saúde. Envelhecimento Ativo: uma política de saúde. Contribuição da Organização Mundial da Saúde para o segundo encontro mundial sobre envelhecimento, realizada em Madrid, 2002. Tradução realizada pela Organização Pan-Americana de Saúde, Brasília, 2005.)-(77. Brasil. Ministério da Saúde. Portaria nº. 2.528,19 de outubro de 2006. Política Nacional de Saúde da Pessoa Idosa. Disponível em: http://www.ciape.org.br/PolíticaPIdosa2528.pdf. Acesso em: 11 dez. 2011.
http://www.ciape.org.br/PolíticaPIdosa25...
. That is, work focused on literacy activities, such as those developed in the Language Workshop, can promote autonomy in elderly people, ensuring them dignity and integration into a literate society, which ends up promoting citizenship attitudes.

It is worth mentioning here about the importance of speech-language therapy in order to create possibilities for the inclusion of the elderly as active members in society by giving them a better quality of life. This fact is in line with the government's concern to provide programs on health and education, work, care and leisure for the aging population, as proposed in the laws aimed at the elderly population, such as the National Elderly Policy55. Brasil. Presidência da República. Subchefia para Assuntos Jurídicos. Decreto n.1.948, de 3 de julho de 1996. Política Nacional do Idoso. Disponível em: http://www.planalto.gov.br/CCIVIL/decreto/D1948.htm. Acesso em: 11 dez. 2011.
http://www.planalto.gov.br/CCIVIL/decret...
, the Elderly Statute66. Brasil. Presidência da República. Subchefia para Assuntos Jurídicos. Lei nº 10741, de 1º. de outubro de 2003. Estatuto do Idoso. Disponível em: http://www.planalto.gov.br/ccivil_03/LEIS/2003/L10.741.htm. Acesso em: 11 dez. 2011.
http://www.planalto.gov.br/ccivil_03/LEI...
and the National Policy on Elderly Health77. Brasil. Ministério da Saúde. Portaria nº. 2.528,19 de outubro de 2006. Política Nacional de Saúde da Pessoa Idosa. Disponível em: http://www.ciape.org.br/PolíticaPIdosa2528.pdf. Acesso em: 11 dez. 2011.
http://www.ciape.org.br/PolíticaPIdosa25...
. Moreover, practices of reading and writing, can contribute significantly to literacy in health aimed at older people, encouraging them to seek, understand and share information that promotes and maintains healthy living conditions1616. Paskulin LMG, Bierhals CCBK, Valer DB, Aires M, Guimarães NV, Brocker AR et al. Alfabetização em saúde de pessoas idosas na atenção básica. Acta Paul Enferm. 2012;25(Número Especial 1):129-35..

Final Considerations

This study indicates that speech-language therapy, here focused on autobiographical accounts, aimed at the increase of literacy practices with the elderly can meet the principles and proposals of healthy public policies for a portion of the aging population, as this work promoted autonomy and active participation by the elderly in the community, as well as increased chances of experiencing healthy and successful aging.

In this direction, we must emphasize the need for and importance of new studies and research directed at the elderly population to consolidate the role of the speech-language therapist in the field of gerontology and their participation in the promotion of health and citizenship of the elderly, restoring the role of language as a constitutive function for the subjects.

Acknowledgements

The National Council for Scientific and Technological Development (CNPq) for financial support for this research, in the form of a Productivity in Research Grant, under registration number 310542/2011-01.

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    Torquato R, Massi G, Santana AP. Práticas de letramento no processo de envelhecimento. Envelhecimento e letramento: a leitura e a escrita na perspectiva de pessoas com mais de 60 anos de idade. Psicologia: Reflexão e Crítica. 2011;24(1):89-98.
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  • Source of support: study financed by CNPq - under registration number 310542/2011-01. Productivity in Research Grant/ PQ 2011.

Publication Dates

  • Publication in this collection
    Nov-Dec 2015

History

  • Received
    13 Apr 2015
  • Accepted
    16 June 2015
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