Living Arrangements and Informal Support for the Elderly

ABSTRACT

A network of informal care and support provided by family, friends and neighbors often forms the basis for elderly care. Changes in the structure of Chinese family alter this supportive function, and changes in traditional values affect the nature of the network and support provided. This is especially so in modernized Hong Kong where the traditional role of the family and especially children's duty of care for their aged parents (“filial piety”) may be weakening. This proposition was investigated by a qualitative study involving in-depth interviews with 50 older persons in a modern new town (Tuen Mun) in Hong Kong. Living arrangements, geographical proximity and the quality of relationships between potential caregivers and the elderly affected needs for and provision of informal support. Traditional Confucian filial piety is undergoing modification, perhaps erosion, implying ongoing changes in inter-generational relations in this modernized Asian society.     

Family Support for the Elderly in Korea

Abstract

This article discusses major issues and concerns regarding family support for parents and elderly people in industrialized and urbanized Korea. It summarizes new trends in family support for elderly members, continuing influences of the traditional value of family support (filial piety), growing needs for public services for elderly people and their families, urgent calls for the state to assume greater responsibilities for providing social security and services for the elderly, needs for cross-cultural studies of family support, and certain cultural similarities and differences to be considered. The article concludes with some suggestions for future research.     

Family support for the elderly in Korea: continuity, change, future directions, and cross-cultural concerns.

This article discusses major issues and concerns regarding family support for parents and elderly people in industrialized and urbanized Korea. It summarizes new trends in family support for elderly members, continuing influences of the traditional value of family support (filial piety), growing needs for public services for elderly people and their families, urgent calls for the state to assume greater responsibilities for providing social security and services for the elderly, needs for cross-cultural studies of family support, and certain cultural similarities and differences to be considered. The article concludes with some suggestions for future research.     

Persistence and challenges to filial piety and informal support of older persons in a modern Chinese society: A case study in Tuen Mun,Hong Kong

Social support networks, consisting principally of family members, neighbors, and friends, can provide various support functions to older persons. As societies modernize, changes in family structure might alter this supportive ability, and changes in traditional values affect the nature of the network and support provided. This may especially be so in rapidly modernizing societies as in the Asia–Pacific region where the traditional role of the family and especially children's duty of care for parents (“filial piety”) may be weakening. This proposition was investigated by a qualitative study in a modern new town (Tuen Mun) in Hong Kong. In-depth interviews with 50 older persons in public housing estates were triangulated with data from focus groups and key informants. Living arrangements, geographical proximity, and the quality of relationships between potential caregivers and receivers affected needs for and provision of support, and there were interactions between various components of informal support. An important finding, which also has policy implications, is that traditional Confucian filial piety may be undergoing modification, perhaps erosion, implying ongoing changes in intergenerational relations in this modernizing Asian society.     

Correlated factors with filial piety expectations of older Koreans and Korean-Americans

ABSTRACT

Changing filial piety expectations have been examined from the viewpoint of younger generations. However, research on older adults’ perspective of this cultural phenomenon is virtually absent from the empirical literature. In an effort to address the changing family life circumstances of Korean and Korean-American families, this study explores older adults’ filial expectations from their own children and correlated factors associated with the expectation. The cross-sectional survey study with 449 older adults found that the majority of respondents still believe that adult children should assume responsibility for the care of their parents. Several factors such as age, education, income, living arrangements, self-rated health, year of immigration, and social support were significantly correlated with filial expectations among older Korean-Americans. Only satisfaction with social support received from family and friends was significantly related to older Koreans’ expectations. Implications for social work practice are discussed and further research directions are suggested.     

The Effects of Parental Divorce: A Culture-Specific Challenge for Young Adults in South Korea

Extensive research into the offspring of divorced parents has indicated associations between parental divorce and developmental outcomes for young adults. Nevertheless the impact of cultural variation on the lives of young people with divorced parents has been neglected. Qualitative research using Interpretative Phenomenological Analysis (IPA) was used to examine the experiences of six Korean adults of divorced parents, who detailed the impact of parental divorce on their lives and told us how their feelings toward their parents and their own ideas about family formation had been reevaluated. Overall, participants expressed concerns in common with other children of divorce and concerns specific to their Confucian cultural context, namely ambivalent feelings toward their parents' divorce, confusion about traditional filial piety, and a view of the self as damaged and needing reinvestment.     

Hong Kong Chinese aging adults voice financial care expectations in changing family and sociocultural contexts: implications for policy and services

Despite being one of the world’s wealthiest cities, approximately one-third of Hong Kong older adults live below the poverty line. Innovatively using the Photovoice research method, this study invited 36 Hong Kong Chinese aging adults to photograph images and voice their concerns and expectations regarding financial care. Insufficient government support, diminishing family support, insecurity and fear regarding future finances, and strong desire for self-sufficiency through early preparation and bridge employment were recurring themes observed in the participants’ photographs and narratives. The shifting of the participants’ financial care expectations from informal to formal sources in changing family and sociocultural contexts indicated that older people are in urgent need of policy reform from a needs-based to rights-based approach to foster empowerment and fulfill older people’s rights of financial security, dignity and participation. Improving the retirement protection system should go hand in hand with encouraging family support and caregiving and creating age-friendly working environment for older residents. The findings of this study may have crucial policy implications for Hong Kong and other aging societies, especially those that share similar filial piety values and have seemingly ungenerous welfare systems.     

亲密有间:两代人话语中的新孝道

当前,现代城市家庭的孝道标准已由"顺从"向"尊重"演化,亲子间的互动模式由"奉养无违"转变为"亲密有间"。因此,建基于个体独立和平等关系的新孝道模式有利于代际间的"自立"和形成有"利他"情感的亲密关系。新孝道提出了更高层次的孝道要求,即对精神赡养的重视(显亲、悦亲强化),而物质赡养成为辅助性要求(养亲、侍亲弱化),使孝道理念回归到基于对父母的尊敬和真挚的爱而"善待"父母。     

Korean American Elderly's Knowledge and Perceptions of Elder Abuse

ABSTRACT

“This study examines Korean American elders” perceptions of elder abuse and its perpetrators and explores cultural, as well as non-cultural influences on such perceptions. Face-to-face interviews were conducted with 100 elderly Korean Americans, 60 years of age or older, residing in Los Angeles County. Respondents reported 46 abuse cases, categorized into the following six types: financial abuse (36%), psychological abuse (24%), culturally specific abuse (17%), neglect (15%), physical abuse (4%), and other (4%). Most respondents identified elder abuse in terms of abrogation of filial piety, suggesting the centrality of “children” in Korean American elders⁵ lives and well-being. Findings demonstrate that employing a uniform definition of elder abuse across all cultures and ethnic groups without attending to the cultural and subjective aspects of a given situation may result in missing problems and needs identified as important by the elderly themselves. Implications for social work practice and program development are discussed.     

Chapter Three

Elder mistreatment is explored from the perspective of the health care professional, beginning with a brief review of relevant values and ethical concepts. These include beneficence, non-maleficence, autonomy, confidentiality, paternalism, filial piety, and justice. The chapter then raises several ethical dilemmas faced by health care professionals in evaluating, reporting, and caring for cases of elder mistreatment. These include the difficulty in balancing patient autonomy with the obligation to prevent them from harm, the problem of confidentiality and reporting requirements, the impact of reporting on relationships with patients and other professionals, and the problems in working with patients and their families. Approaches to developing appropriate institutional responses are suggested. The chapter concludes with a discussion of the three cases.     

Long-Term Care for Elder Women in Spain: Advances and Limitations

In Spain, elder women are the largest group in need of long-term care. Significant improvements in this issue took place between 2007 and 2011, thanks to the Dependency Law (2006). But severe limitations showed the difficulty of overcoming the historical backwardness of Spanish social policy. This article describes the situation of Spanish people with dependency in activities of daily living. It analyzes changes driven by this law, especially in their impacts on elder women. It assesses the extent to which those changes can alter the traditional model of care. There are three major findings: First, measures promoted by the law have improved the previous situation but are incapable of developing a new model. Care for elders still relies on family, with lack of professionalism, little socialization, and expanding commodification. Second, the current care model is fundamentally detrimental to older women and women caregivers. Third, this kind of model hinders the overcoming of gender inequalities in intrafamily, generational, and social relations.     

Residential Differences in Filial Responsibility Expectations Among Older Persons1

Abstract This study examines variation in filial responsibility expectations-the extent to which adult children are expected to assist and care for their aging parents-among a sample of 440 older persons. The analysis focuses on the relationship of filial responsibility expectations to residential location and tests the hypothesis that older rural residents have higher expectations for assistance from their children than do older urbanites. Current residential location is found to have little impact on expectations, but older persons who were raised in rural areas, particularly on farms, have significantly higher expectations for filial assistance than do older persons from urban backgrounds. Possible consequences of these patterns for the transmission of expectations from parents to children are discussed.     

Love thy parents and care for thy children: Filial piety and intergenerational cooperation in traditional China

This article provides an economic reason to explain why agricultural production in traditional China has been organized within the family for the past two millennia. By holding other factors constant, we show that the allocation of resources within a society that practises filial piety is superior to that of a society without filial piety. The institution of filial piety began by the Confucians and the government of the Han Dynasty (two millennia ago) helped to enforce an arrangement between father and son for the exchange of their ownership of resources. Filial piety and order in the family are the central pillars of Confucianism and Chinese culture because order in the family is crucial to realizing a better allocation of resources in society. This also explains why the traditional Chinese or Oriental societies have embraced Confucian values for more than two millennia.     

Cultural and Ethical Issues in Korea's Recent Elder Abuse Reporting System

The primary purpose of this article is to examine the relevance of cultural values, such as familism and individualism, that influence public policy implementation processes for protecting older adults in Korea and the United States. The secondary purpose is to identify ethical dilemmas and policy implications for effectively implementing the recently developed public law designed to protect vulnerable older adults in Korea. This article discusses both similarities and differences found in the two countries' elder abuse reporting systems and the service delivery systems for protecting older adults at risk of abuse and neglect.     

农村家庭养老中的孝文化缺失解析

孝文化是维系农村家庭养老的重要因素。由于社会变迁、农民价值观多元化和家庭结构变化等原因,致使现今农村孝文化缺失,家庭养老功能日趋弱化。加强青少年孝文化教育与法制建设,发挥政府的主导作用和社会舆论的导向作用,大力弘扬传统孝文化,赋予孝文化时代新内涵,积极倡导孝亲敬老之美德,对有效解决日益突出的农村家庭养老问题具有深远的现实意义。     

Issues of elder care and elder abuse in the Indian context

With 7% of the population of India being elderly, two-thirds of whom live in villages and nearly a half of them in poor conditions, the care of the elderly is a difficult problem to be tackled. The dwindling of the joint family, the rise of dual-career families, a possible shift in filial piety values, the increasing life expectancy with greater chances of a prolonged old age characterized by poverty, degeneration, more empty-nest years, and dependency, have all added to the seriousness of the problem and made the elderly more susceptible than ever to abusive treatment. This paper examines these issues as well as the issue of elder abuse in light of available data and suggests some strategies to meet the problem. Also discussed are the problems, stresses, and strains of caregivers of the elderly. A greater role is envisaged for Non-Governmental Organizations (NGOs) than the state in the care of the elderly, particularly in providing support services to family caregivers.     

家庭价值观结构、代际变迁及其影响因素

对中国家庭价值观核心结构、核心家庭观念的代际变迁及其相关影响因素的研究表明,中国家庭核心观念包括孝道观、男性中心观和家庭本位观3个方面。除了男性中心观呈现明显的"代际"下降趋势外,孝道观和"家庭本位观"基本没有出现代际差异。这表明在传统农业文明和现代工业文明的双重影响下,中国家庭核心价值观认同表现出一定的选择性。从中我们既看到人们对传统价值观的坚持,又能看到现代家庭观念的发展。     

Recent developments in institutional elder care in China: changing concepts and attitudes

This study examines recent developments in institutional care for Chinese elders and attitudinal changes toward institutional care in Tianjin, China. Based on studies in 12 elder home sites and survey interviews with 265 older residents, this study compares institutional differences between government and non-government-owned elder homes, and examines elders' evaluations of elder homes' quality and their level of willingness to stay in elder homes. Findings suggest that government-owned elder homes still enjoy institutional and bureaucratic privileges in funding, staffing, and insurance. Elders' overall evaluation of elder home quality was high. Elders' former living arrangement and financial ability were related to their willingness to stay in the elder home. The unfair competition between governmental and non-governmental elder homes is likely to hinder the development of elder home industry in the free-market system and foster a growing gap between the rich and poor elders in their capability and decisions in elder home care. As adult children become increasingly unavailable due to the one-child policy and geographic mobility, institutional care for aging parents is likely to become one of the major options for parent care.     

Decisional conflict among Chinese family caregivers regarding nursing home placement of older adults with dementia

Purpose: To describe factors influencing decisional conflict among Chinese family caregivers regarding nursing home placement of older adults with dementia. Design and Methods: Individual interviews were used to collect data with 30 Chinese family caregivers of older adults with dementia in Taiwan. Data were analyzed using thematic analysis. Results: Factors influencing caregivers' decisional conflict included the Chinese value of filial piety, limited financial resources and information, placement willingness of the older adult, family disagreement, distrust of nursing home care quality, and limited nursing home availability. Factors influencing caregivers' decisional conflict post placement included disappointment with nursing home care quality and self-blame for the placement decision. Implications: Findings resulting from this study indicate that Chinese family caregivers experience decisional conflict during the nursing home decision making process as well as after the placement decision. It is important to provide appropriate decision support beginning before admission and across the trajectory of the older person's nursing home stay in order to decrease decisional conflict and facilitate a more positive decision making process for caregivers, family members, and older adults with dementia.