Post on 21-Jan-2016
The Nethersole School of Nursing
The Chinese University of Hong Kong
Engaging the Public:Local Strategies for Chinese elders
Diana Lee
Chair Professor of Nursing and Director
An Outline
• Successful aging – the literature
• Successful aging – views of Chinese elders
• Implications for local strategies to engage Chinese elders
Successful Aging – The Literature
• Factors associated with successful aging: physical and psycho-social indices
• Successful agers:
- achievement of developmental tasks of later life
- ‘productive’
- functioning physically and psychosocially above ‘normal’
Cautionary Questions
1. Not adequately grounded in elderly people’s actual experiences and views. Some beginning work:
more emphasis on well-being and social functioning than physical and psycho-
cognitive functioning
the ability to adjust to circumstances
focusing on gains rather than losses
Cautionary Questions
• Differences between elders’ and researchers’ perspectives on successful aging:
elders’ views: more multi-dimensional, less emphasis on functional aspects;
sense of satisfaction and adjustment seen as more important
(Phelan et al 2004)
Cautionary Questions
• Successful aging as a state of being
measured objectively by clinical standards
vs • Successful aging as a continuous adjustment
process
Cautionary Questions
2. Socio-cultural considerations highly neglected
Existing knowledge on successful aging: a strong Western bias
Individual accomplishment
vs
Collective orientation
Cautionary Questions
• Keith et al (1990): explore the aging experience of elders of different cultures
Americans: self-sufficiency, ability to live alone, how they view the world
Chinese: families’ willingness to meet their needs, how others view them
So……
• Successful aging is a socially and culturally determined construction
• The need to develop understanding of the diversity and commonality of the aging experience across cultures
engage elders in culturally relevant interventions to promote successful aging
Successful Aging – Chinese Elders
A grounded theory study on community Chinese elders in Hong Kong:
Meaning of successful aging
• Being engaged in life
- a life-course concept
- active view of aging
Successful Aging – Chinese Elders
Conditions of successful aging
• Harmonious family relation
• Independence in daily functioning and self-care within one’s physical ability
• Positive orientation to life in general and old age in particular
• Adequate social contact
• Sufficient financial resources
Successful Aging – Chinese Elders
Strategies to age successfully• Sustaining harmonious family relationship• Striving to keep one’s physical, psychological
and social health
Influences of Chinese cultural beliefs• Protecting the family’s face• Maintaining harmony• Being thankful
Implications
“Go in search of people.
Begin with what they know.
Build on what they value.”
Chinese proverb
Engagement strategies should therefore
Focus on and result from the needs, expectations and desires of the Chinese elders
What to consider before starting the engagement effort?
Elders’ previous life experiences and its impact on their engagement
• Life experiences in its totality
• Experiences of earlier life stages shape later life experiences
What is necessary for engagement to occur?
Fitting into elders’ biography – A life-course approach
• Strengths and resources
• Physical, psychosocial and financial
What to consider for the engagement to be successful?
Family-centred approaches/ strategies
• Focus on the family as a unit
• Promoting family responsibility
• Strengthening family action
• Creating a supportive environment for family growth and functioning
Re-orientation – Thinking and Practice
• A medical approach to needs assessment
A biographical approach to understanding elders’ life experiences
elders’ psychosocial, cognitive and behavioural resources
Re-orientation – Thinking and Practice
• Individual/ personal ability and action
Promoting, maintaining and restoring family functioning across life cycles