Caring for Elders in China
The Role of Family in China's Old-age Care : A Study of Two Chinese Cities
Paper Presentation in a Themed Session Pui Ling Ada Cheung
Throughout China’s history, one’s family seems to have always been a critical insurance for one’s welfare in old age. Yet, with demographic change and economic transitions, the sustainability and practicality to rely on individual families to care for older people has attracted much debate and social concern since the 1980s. To understand the changing social expectations and the corresponding societal responses, the shifting perception of the rights and responsibilities associated with the family care of older people has to be comprehended first. Based on thirty-nine interviews with key stakeholders (older people, academics, officials, and NGO staff) in two Chinese cities, Beijing and Guangzhou, this paper examines the changing perspectives of family’s role in old-age care. Rather than seeing their families as the default provider for their wellbeing, most older people interviewed have taken more responsibility for their life decisions and have actively sought alternative resources to secure a fulfilling retirement. This research contributes to an understanding of the pursuance of a "good life" by older people in contemporary urban China. It points to the argument that independence and autonomy in old age, as valued by the interviewees, will not be realised unless there is a shift in policy to recognise and respect the individuality of older people and facilitate their life choices.
Characterising Long-term Care (LTC) Needs Among Chinese Elderly : Findings From a Large Social Survey
Paper Presentation in a Themed Session Yi Yang
With rapidly ageing in East Asia, it has become imperative to better characterize the prevalence and nature of long-term care needs (LTC) among the elderly. This study investigates LTC needs in the context of old adults who face limitations in activities of daily living (ADL) or with cognitive impairment (CI), and thus need aids to fulfil daily activities. Drawing data from three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study shows that about 18 per cent of the Chinese elderly aged 65 to 99 reported LTC needs in the baseline year of 2002. These proportions increased to 20 per cent in the final wave of 2008/09. Results from panel regression models indicate that factors such as (i) low income, (ii) inadequate medical services, (iii) lack of social support and social activities, (iv) under-consumption of fresh fruits, (v) emotional distress and (vi) ageing are the factors that positively contribute to LTC needs. Furthermore, this study also shows that the effects of family-related factors can be mixed. Being spouseless is a risk factor for LTC needs but childless elders are less likely to have LTC needs. However, these associations are explained by age and rural/urban residence. These results may reflect the changing elderly care dynamics in China with a shrinking family size and fewer adult children available for elderly care as well as the urgent need to build up public LTC system.
Activity Engagement Among Older Residents in China’s Long-term Care Institutions and Their Self-reported Activity Change after Relocation
Paper Presentation in a Themed Session Honghui Pan
Activity engagement is an important part of older adults’ well-being, as advocated in the World Health Organization’s “healthy ageing” agenda. Whereas activity engagement is often defined among community-based older adults and from a youthful perspective, this study, using focus group methodology, investigates activity engagement among forty older residents in two Chinese long-term care facilities in Beijing and Suzhou in China. We examine the portfolio of activities existing within these institutions and analyze residents’ perceptions of changes to their activity patterns following their move into long-term care. Our results specify seven domains of formal activity participation and eight domains of informal engagement among our sample of older care home residents. Regarding alterations to activity patterns following relocation, three self-perceived changes were identified: freedom from daily chores, an increased choice of companionship, and lost old hobbies with new ones developed. Implications are discussed from the perspective of the Chinese culture influence of Confucianism, and policy recommendations are put forward.
