Senior Care in China: Successes and challenges of senior care facilities

Students: Katherine Campbell, Capri Backus, and Kyle Carroll

A discussion on the current issues on senior care in China with Dr. Hui Li and her students from the Qindao University of Petroleum

Project abstract

In summer 2017, the Washington & Jefferson College team conducted a three-week field research project on senior care issues in China. The team was mentored by Dr. Ye Han, the Chinese language professor at Washington & Jefferson College. The team included three student researchers: Capri Backus, Katherine Campbell, and Kyle Carroll.

Senior care is a complex and broad topic. In order to conduct a fulfilling field research project in a rather brief period of time, prior to the trip the research team engaged in a semester long literature review, including reading recently published journal articles and current news on senior care in both China and the United States. In addition, the student researchers also participated in a series of Chinese culture and linguistic training sessions provided by Dr. Ye Han. These project issues-related, cultural and linguistic preparations helped the student researchers to conduct successful interviews when they were in China.

During the three-week trip in China, the team visited five senior care facilities in two Chinese cities: Beijing and Qingdao. In each senior care facility, they interviewed administrators, senior caretakers, social workers, and the senior residents. Through these interviews, they investigated the private and government-run facilities, the cost and business operations of senior care facilities, and the training for doctors, nurses, and helpers at the senior care facilities. After each visit, the team always had a debriefing meeting to complete their field notes, analyze the data they collected, and discuss the questions in their mind.

In addition, visiting senior care facilities, the team also actively interacted and conversed with a variety of local people, including retirees at local senior activity centers, parks, and senior sports centers; undergraduate and graduate students from the local universities; and taxi drivers who are taking care of their senior parents. By communicating with them, the team discovered the difference between generations in terms of their opinion toward nursing home. By approaching the research topic from a variety of perspectives, the students learned valuable research methodologies and strategies which they can use in their future professional endeavors.

Katherine Campbell

Katherine was talking with a care provider at Sanhe Nursing Home in downtown Beijing.

Two other students, our professor, and I spent three weeks in Beijing and Qingdao, China, this summer researching the emergence of nursing homes in the country. In addition to touring nursing homes in Beijing and Qingdao, we also talked to administrators, workers, and residents about the procedures at the nursing homes, the training of the staff, and the quality of life for the residents. We looked for differences in private and public nursing homes and reflected on our expectations versus the reality of what we found. We also investigated the public’s personal opinions about the emergence of nursing homes, finding a surprising difference in the opinions of older individuals versus younger individuals.

As all of our research was conducted in Chinese, this experience served to greatly improve our skills in the language, especially with speaking and listening. For me personally, this experience taught me to be confident in my current abilities with the Chinese language, but it also taught me that I have so much more to learn in order to be comfortable with the language. Finally, this project also taught the three of us students about group work and how to combine our skills and resources to most efficiently face the challenge of conducting research in a country, as well as a language, that is not our own.

In explaining and then discussing our research with various people over the past year, I have actually further defined my thoughts about the topic that we researched. Every time I tell people that we studied the emergence of nursing homes in China, they inevitably ask how the nursing homes that we visited in China compare the nursing homes in America. The more I think about this comparison, the more I believe that the nursing homes themselves are really not so different between China and America. It is the public sentiment about nursing homes, I often tell others, that is what is different.

In America, it has become an accepted part of society that elderly citizens will eventually move into a nursing home. In America, there is not even a strong expectation that children will visit their elderly parents in nursing homes. In China, the expectations and feelings about elderly citizens entering nursing homes are quite different. While we were in China, we saw a dichotomy of opinions regarding the feelings about putting elderly family members in nursing homes. On the one hand, all of the elderly citizens that we talked to who we either met in nursing homes or out in the streets said that they wanted to go into nursing homes because they did not want to burden their children. On the other hand, all of the college-aged individuals that we met felt that it was wrong to put their elderly parents and grandparents in nursing homes because that would be violating the long-held cultural value of filial piety. While there were differences in opinions, I did get the impression that there is an underlying sentiment that nearly everyone wishes that the elderly citizens did not have to go to nursing homes. These complicated feelings based in filial piety were very different from the feelings that Americans have about nursing homes.

Learning about the culture in China also helped me to complete my honors project on Chinese American literature this year. My honors project discussed a model for identity conflict and resolution suggested in literature by and about Chinese Americans. As part of my project, I discussed the differences between collectivism and individualism and the impact that these two different cultural models have on the Chinese culture and the American culture. While thinking about the collectivism in the Chinese culture, I was able to pull in memories from my time in China that revealed the collectivist values in the Chinese culture.

Overall, I believe that this research project in China helped my learning and development in many areas. Through this project, I had an opportunity to learn about the Chinese culture, the Chinese language, the deep-seeded feelings about filial piety in China, and the development of nursing homes in China. While completing and later reflecting on this project, I was able to develop my skills in written communication through the proposal and reflection essays, my oral communication skills through interviews with people in China and through presentations about our research after returning to America, my ability to work in a team through working with two other students to develop and execute this project, and my ability to communicate to people who do not speak the same language that I do or observe the same culture that I do. I plan to continue to use what I learned and developed in China this past summer as I graduate from college, move into graduate school and later the professional world, and hopefully someday soon return to China.

Capri Backus

Visited Chengyang senior wellness center in Qingdao with Dr. Hui Li and her advisees from the Qindao University of Petroleum

Immersing myself in the people and culture of China allowed me a deeper and more personal understanding of the issue my team wished to research: nursing homes and its perceptions. Traditional Confucius culture dictates that a “good” child must care for their elderly parents. A rapidly aging population, however, places too much stress on the family unit to care for the elderly; subsequently, private and public institutions for elder care are becoming more prevalent in China.

From a distance, it seemed like many elderly residents in China perceived nursing homes with a sense of moral anxiety and shame. As our team travelled in China—gaining new skills in teamwork, collaboration, analysis, interviewing, and problem solving—we soon met the people that seemed to prove the exception and to break the rule. Visits to nursing homes, parks, senior recreational centers, museums, and more helped me to gain a deeper insight into facets of Chinese culture, and how culture seems to function among different demographics and places. These interactions illuminated aspects of culture that we had studied, such as Chinese culture’s family-oriented culture, as well as showcased individuals’ unique takes: defiant, family-adverse grandparents, culturally-liberal taxi drivers, and more culturally-conservative students all depicted a wide spectrum of diverse thought. This experience helped me to understand the value of connecting with others through travel, dialogue, and collaboration. In addition, I’ve built up the skills to understand, analyze, and persevere: traits and skills that will guide me in any field that I wish to pursue for the future.

The twin themes of personal and academic growth followed us as we began to construct our presentations and our posters. One of my greatest challenges in academia, beyond the challenges in understanding and analyzing knowledge, is the deep anxiety of learning the relevant ropes of the profession. Would I be able to present this information well? Could I even construct an academic poster? Pushing myself, and being encouraged by countless mentors, to finish these projects to the end has given me an invaluable peace of mind for the challenges ahead, as well as a foundation from which to work with in regards to a fuller understanding of both my strengths and weaknesses from which I can learn. In other words, I know that it is possible for me to work well within a team, and to create academic work. Additionally, the opportunity to meet extremely curious, ambitious, and open-minded peers fueled the fire that I have to explore further questions, and of the great insights that collaboration and great conversations that professionalism can produce. For the future, I plan to work to try and to present an essay in addition to a poster at the conference next year, to challenge myself further.

In sum, personally experiencing a piece of the process through which scholars draw on past repositories of knowledge to investigate critical questions has allowed me to experience some of the wonder of following large, complex theories down to the individuals behind these forces. Doing so has given me a much more nuanced, complex, view of the world, as well as of China, that allows me to ask better questions, and to take less knowledge for granted or for face-value. I want to deeply thank the ASIANetwork Freeman SFF program for this invaluable experience, as well as for the future challenges that I will pursue due to the chance to push myself last year.

Kyle Carrol

Capri, Katherine, and Kyle posed with a senior Chinese opera group after watching their daily practice.

Although China differs from the United States in many ways, China has some similarities regarding its care for seniors. With this project, I was provided the opportunity to personally interview experts at senior care facilities to study their finances, funding, and daily operations in Qingdao and Beijing. Through these interviews, I found that the motives behind senior care facilities were the same. I learned specifically differences between operations of private and publicly owned senior care facilities and determined the advantages and disadvantages for both strategies in starting up a business. Throughout the trip, I determined that caring for seniors is a major focus for the people of China, which can be compared that to the United States. From conversing with locals, I found that students felt obligated to take care of seniors; however, seniors feel differently and do not wish to financially burden their children with their care. Subsequently, some seniors choose to reside in senior care facilities. This was a theme throughout China.

This trip significantly improved my language ability and communication skills in Chinese. Aside from learning a new culture, I gained invaluable experience developing skills in analyzing business operations at senior care facilities. I improved my ability to converse intelligently in Chinese about business entities and to interact with locals. This project advanced my understanding on how to manage businesses. It also provided important considerations needed for starting up a business through funding, which will greatly influence my life pursuits in the future.

In terms of career preparation, this project has directed me to the field of finance for a private industry. Having no experience in finance, other than this project, I was able to secure an internship with the University of Pittsburgh Medical Center. Through a couple interviews, I have obtained in internship as a finance associate for UPMC for this coming summer. For majority of my interview, I discussed mostly the work I conducted in China and what results I found regarding finances. I also discussed the whole research project and what my team members and myself did during the trip to China in great detail. Without this experience, I most likely would not be qualified enough for this internship. I presented our findings to future students at my college pursuing education in Chinese and faculty interested in the topic. I traveled to Philadelphia from April 6-8, 2018, to present our findings from our trip to China. Many people were very interested in the topic and asked many questions regarding our research. I am grateful to be provided this unique opportunity. It allowed me to share my findings and my learning experience to fellow students at my college. I also feel honored that I represented my school to present our project at the ASIANetwork Annual Conference in Philadelphia.