María Pilar de Abiega Sauto

María Pilar de Abiego Sauto has developed a participatory, peer- and community-based model of senior living that gives elderly Mexicans an alternative to living in a traditional nursing home. As a member of various advisory bodies and senior citizen networks, she advocates her model as a tool to secure senior citizens’ rights to an active and fulfilling life at a time when they are more likely to be abandoned.

María Pilar founded and developed Comunidad Participativa de Tepito (COMPARTE) or Participatory Community of Tepito, as an alternative model of elderly care that allows senior citizens to remain in their homes or in places where they can continue to develop their skills, life projects, and dreams, while feeling useful and loved. In COMPARTE, many seniors come to realize that life is still worth living, they still have something to contribute to their communities, and they have a support network in the final years of their lives. COMPARTE acts as a surrogate family for the many elderly people in Mexico City who find themselves alone or abandoned. Unlike the traditional nursing home model, which often treats elderly residents like hospital patients, María Pilar’s COMPARTE model allows elderly Mexicans to continue living at home or in their own neighborhoods and, depending on their abilities, to play an active role as caregivers for their less able-bodied companions or to receive that care from their peers. Besides her active role in the daily operations of COMPARTE, María Pilar is a vocal advocate for senior rights at the municipal, state, and federal levels of Mexican government through her membership on various advisory bodies. She has taken advantage of these forums to convince other citizen organizations and government agencies that deal with senior citizen affairs to adopt aspects of COMPARTE; thus, laying the foundations for the replication of her model throughout Mexico.

Aging populations have become a serious concern for many industrialized countries that have benefited from advances in technology, pharmacology, and health care—advances that threaten to overwhelm public services as well as individual families unprepared to deal with an exploding elderly population. Like the U.S. and some European countries, Mexico is currently facing the challenges of accommodating a burgeoning elderly population. Since 1950, the aging of Mexico’s population has accelerated sharply. Today, 1 of every 15 Mexicans (7.3 percent) is over the age of 60; that figure is expected to rise to 2.5 of every 15 (17.5 percent) by 2030 to 4 of every 15 (28 percent) by 2050. In other words, the number of Mexicans over the age of 60 will increase from 8.4 million in 2006 to 36.2 million in 2050.

Traditionally, elderly people have played a pivotal role in Mexican family structure. Mexicans’ emphasis on extended family led many households to include not only the nuclear family but also grandparents and even great-grandparents. Various factors have recently brought about a shift in this pattern. First, contemporary Mexican society highly values youth, beauty, and productivity. Since the elderly do not fit these criteria, they are increasingly marginalized, abandoned, and mistreated. Second, incessant waves of migration from Mexico to the U.S. have left behind elderly members of many families. Finally, Mexican households have been shrinking in recent years, partially due to American cultural influence and partially to the growing pressures on the size of urban households, such as limited and expensive housing and the rising costs of living. As a result, a growing number of elderly Mexicans end up alone or abandoned by their families.

These changes have helped to fuel an increasingly deprecatory attitude towards the elderly in Mexico. Paradoxically, even institutions dedicated to senior care, such as nursing homes and assisted living communities, are often patronizing and over-protective towards the elderly. María Pilar raises an example of the Director of a nursing home who refers to her residents as “my little old people” and whose staff treats the residents as invalids or small children, feeding, clothing, and entertaining them with television or other vapid diversions. These attitudes assume them a burden with little or nothing to contribute; instead of giving them the respect they deserve.

The most pernicious aspect of this attitude is its effect on the elderly. Seniors internalize the dismissive attitudes of those around them, which leads to greater dependency and a diminished will to live. To illustrate this, María Pilar cites a curious statistic: Whereas, 40 of the 46 residents in the nursing home mentioned above wear diapers, only 2 of 130 residents do in COMPARTE. Through countless conversations, María Pilar has concluded that senior citizens strongly dislike the idea of spending the last years of their lives in nursing homes and treated like invalids. They prefer to stay in their homes and neighborhoods and feel needed and loved. This realization has driven and shaped her model over the last two decades to enable the elderly to live with dignity.

Constituted in 1989 as a nonprofit organization, COMPARTE, (meaning “share”) caters to the elderly in the rough-and-tumble neighborhood of Tepito in Mexico City. After the Mexico City earthquake of 1985 rendered 80 percent of the homes in Tepito uninhabitable, María Pilar realized the population most in need of support—the elderly—were being abandoned by younger family members. She also knew most of them wanted to stay within the familiar environs of Tepito rather than be sheltered in nursing homes elsewhere. In response, María Pilar created the COMPARTE model in Tepito.

COMPARTE is an alternative model to the nursing home because it encourages seniors to play an active role in their care as well as the care of other seniors. All COMPARTE’s activities and operations are coordinated at a day center in Tepito, operated by a full-time administrative team of professionals and overseen by a board of directors, including senior citizen members of COMPARTE. COMPARTE has largely been financed through donations as well as federal and local government funds. COMPARTE’s seniors collaborate in the day-to-day management of the organization, thus making them stakeholders deeply invested in COMPARTE and their peers. Unlike typical nursing homes, the senior members of COMPARTE continue to live in their homes or in one of the 23 houses in Tepito owned by COMPARTE. They convene daily at the center to carry out their activities.

Each member is invited to join one or more of COMPARTE’s four committees: Integral and Preventative Health, Housing, Companionship, and Recreation. Each committee assumes responsibility for a particular aspect of life at COMPARTE. Members of the Health Committee attend trainings run by the local government to become health advocates, and they visit member too frail to regularly attend the day center; checking that these housebound seniors are eating well and taking their medication and assembling parcels of food for delivery to seniors who cannot go to the market on their own. The Housing Committee also visits housebound seniors who can no longer manage their own cleaning and housework, and recruits able-bodied neighbors as volunteers to assist with these tasks. As its name suggests, the Companionship Committee accompanies seniors to medical appointments and other important engagements so they do not go alone. While members of the Recreation Committee organize various activities at the day center; they recruited a tai chi teacher to lead exercises and every Wednesday arrange a meal and social gathering at the day center. The purpose of these committees is twofold: They offer a valuable service to those seniors more physically frail and more vulnerable, and, they empower more able-bodied seniors to directly support their companions, feel needed, and useful. This dynamic creates a tight-knit, participatory community in which the elderly care for each other and build strong social links.

As simple as the COMPARTE model appears, it is completely different from the typical nursing home in Mexico. In the case of COMPARTE, seniors can remain in their homes, living in familiar neighborhoods surrounded by familiar neighbors. Those seniors able to do so help care for their companions through the various committees, which boost their sense of utility and their desire to live. The elderly no longer able to care for themselves can count on a broad support network of peers to help them get through the difficult final years of their lives. Moreover, the COMPARTE model reinforces the social fabric not only among its elderly members but also among staff, family members, and neighbors, demonstrating how seniors can contribute actively and positively to society. María Pilar insists that through this model, seniors realize there is still more to live for, and can face the prospect of death feeling supported by a surrogate family rather than utterly alone. Both the elderly and those who come into contact with them experience an attitudinal shift that resists the deteriorating respect for the elderly in Mexico.

In 2003 the Mexican Ministry of Social Development singled out COMPARTE as the organization with the best practices in elderly care in the country. María Pilar is documenting COMPARTE’s operations with the Fondo de Estrategia Social (Social Strategy Fund), which has provided a grant specifically for this purpose. Their goal is to create a social franchise that can be easily adopted by other organizations. María Pilar hopes to see four new COMPARTE centers operating by 2015 in addition to seeing systemic changes in the way that other organizations and senior care facilities treat the elderly.

To introduce key elements of her model to other organizations, María Pilar participates in several government advisory bodies and nonprofit networks that have allowed her to successfully promote her new approach to senior care. She is a member of the municipal government of Mexico City’s advisory council for defending senior citizens’ rights; the Red Iberoamericana de Asociaciones de Adultos Mayores (Ibero-American Network of Associations for the Elderly), an organization that covers all of Latin America as well as Spain and Portugal, in which she represents the federal district of Mexico City; the Instituto Nacional de las Personas Adultas Mayores (INAPAM or National Institute for the Elderly); and the Red de Adultos Mayores (Network for the Elderly), a consortium of 22 nonprofit organizations working with the elderly in Mexico City, with plans to expand nationally. Through these various advisory bodies and networks, María Pilar has convinced Mexico City’s government to implement part of the COMPARTE model in its senior care centers. She has also convinced some of the 22 member organizations of the Red de Adultos Mayores to allow the elderly a more active role in their own care. Through the INAPAM, she has helped to review federal legislation concerning the elderly, negotiating with federal legislators to incorporate aspects of the COMPARTE model in new legal reforms. Her goal is not merely to replicate COMPARTE centers, but to truly transform governmental and societal attitudes towards the elderly, and modify existing institutions to mirror the fundamental principles of COMPARTE.

From childhood, María Pilar was brought up with the principle of egalitarianism, in which all individuals deserve respect and love regardless of their financial or social status. At eighteen, she left Mexico with her family to live in Spain, and studied to be a teacher. However, her inclination to work with the most marginalized sectors of society gradually grew stronger. At twenty-three, she chose to remain single, become a lay missionary, and devote her life to working for others.

At thirty, María Pilar moved to Chile and worked with a church dedicated to serving the poor for six years. During this time, she read a book that affected her deeply, Los hijos de Sánchez (The Children of Sánchez), an anthropological study of a family living in the Tepito slum in Mexico City. When the military coup overthrew Salvador Allende’s government in Chile in 1973, she moved back to Mexico to live and work in the neighborhood where the children of Sánchez lived.

In Tepito, María Pilar focused her energies on housing cooperatives until the 1985 earthquake struck Mexico City, triggering important changes in her work and defining what would become her priority for the rest of her life. The quake destroyed or severely damaged as much as 80 percent of all the housing in Tepito. Seniors were one of the most vulnerable sectors of the population because they did not qualify for any of the municipal government’s support programs. Other support groups proposed the establishment of standard nursing homes for the displaced elderly, an idea that María Pilar opposed on behalf of Tepito’s elderly. It was during this crisis that COMPARTE’s model arose. With 130 senior citizens participating in the program, it has been operating in Tepito ever since.

María Pilar’s COMPARTE model has been widely recognized as a success by both government-sector and citizen-sector entities. Her goal is to spread the model through regional and nationwide networks and to influence government policy throughout Mexico.