getting ready to chatKaohsiung and NKNU

Aging in Asia

Kaohsiung & NKNU

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Social identity: some definitions According to Hagstrom & Wertsch (2004) “Sarbin (2000)

characterizes social identity as the particular ways that aspects of selfhood arise out of the meanings that people attribute to their experience through the use of self-narratives shaped by cultural determinants.”

Identity is a process which is socially co-constructed. Social identity can include a person’s notion of aging and the degree to which a person identifies with getting older. Jones (2006) reports on how older people position themselves in varying identities in discussions where either being seen as aging or accepting aging could be seen negatively.

Hagstrom & Wertsch 2004. Grounding social identity for professional practice. Topics in Language Disorders 24

Jones 2006. Older people talking as if they were not older. J Aging Studies 20

Social identity: example from the doctor’s office Social identity is embedded in larger sociocultural constructs.

Cultural determinants include expectations about personal narratives.

How we hear stories told by older persons can have implications for medical care. In a recent study in the Netherlands on multicultural general practice settings, Harmsen et al (2005) found that patients’ ethnicity, age, and language proficiency were the most important predictors of a successful physician-patient consultation:

“in consultations between a patient and physician with a different cultural background the discrepancy between their views on illness will be large.”

Harmsen et al, 2005. Assessment of mutual understanding….Patient Education and Counseling 59

Are our expectations about social identity of older people changing?

Do younger people have different expectations about older people?

Do older people have different expectations about themselves?

Where do our ideas about each others’ cultures come into play?

Aging across Asia: highlights Higher life expectancy, already 80 yrs at birth in Japan, will

move across much of Asia by 2050. Fertility is now lower… keyed to the degree of modernization

and the formation of a new middle class. This class now lives away from the workplace and has nuclear instead of extended families. There is a greater gender difference in need for services, increased by longer life expectancy. Changes in social participation emphasize social outreach to the community by older persons. Life satisfaction, however, is dropping, particularly in urban areas.

There are problems with establishing pension and health care systems, and with promoting measures to “help elderly with employment, social participation, and finding a purpose in life”

Sagaza, H. 2004. Population aging in the Asia-Oceania region. Geriatrics & Gerontology International (online)

Liu & Tinker 2003. Admission to nursing homes in Taiwan. Social Policy & Admin 37 Under the government’s long-term care policy, the

establishment of registered nursing homes has been encouraged and numbers increased from 31 in 1997 to 123 in 2001.

Used 265 survey-data interviews with families and 235 with older persons already in nursing homes, conducted in 2001, to look at how families make the decision to admit to nursing home. Adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision.

What were these the main factors that influenced the placement of these frail elderly people?

Expectations for family roles Liu and Tinker (2003) add: “What is different in Taiwan, as in many countries of

East Asia, is the expectation in Chinese culture that the multigenerational family is the ideal. This makes a move to a non-family situation difficult to explain to the older person and to outsiders. It can bring a sense of shame to all concerned….

In Taiwan it is sons who have the key role in responsibility for their parents although it is the women (often wives) who often undertake the caring role. Expectations of support in old age from sons are common.”

Perceptions about quality of life For elderly Chinese in Taiwan… “person-environment

interaction is a major consideration in the evaluation of QOL; family ties are an important component of QOL; traditional Chinese beliefs exert a positive influence on perceived QOL; and social functioning and vitality have a different meaning in Chinese compared to Western cultures….

In our study, elderly persons expressed their vitality by engaging in social activities, exercise and leisure activities... Being energetic may not be a norm for Chinese elderly people.” The authors add their pleasure that the participants could express themselves so well

Leung, Wu, Lue & Tang 2004. The use of focus groups in evaluating QoL components among elderly Chinese people. Qual of Life Rsch 13

In a 2006 exchange, UNCC students asked these questions: Are traditional ways of communicating with the

elderly still used by children in younger generations?

Do you feel that the idea of filial piety is still strong in Taiwan? In what ways has it changed?

Are there constraints on speaking about health issues, specifically about issues that older people may face?

More questions from 2006 group

How are the elderly individuals with cognitive impairment (i.e. Alzheimer’s Disease, Dementia, etc.) treated?

How do the Assisted Living Facilities (Nursing Homes) function in your society? Are the attitudes surrounding them positive or negative?

What type of caretaking roles do the younger generations take on with the elderly? For instance, do grandchildren help tend to their grandparents during their aging years?

Do families live together or very near each other?

Kerns 2007 on QofLife I think I understand my grandparents constant need to be

involved in my life and give me advice about everything – they just want to feel useful. Now that none of their children need them they live alone, my grandfather gardening while my grandmother uses any excuse to get out of the house. She pretty much searches the pantry to find something they don't have that they “need” – orange juice, cereal, peanut butter – and then HAS to leave to go get it. I though that with their large retirement fund and their comfortable lifestyle they were happy, but now I suspect they want to be needed and want to feel more useful. I think that elderly American people need their family too, but that because of the stress on independence in our society they ignore this need or hide it. Maybe elderly Chinese people are more able to have a higher quality of life because of the culture that permits them to be surrounded by their family.

The graying ofTaiwan (TR 2006)Seventy-year-old Lai Chia-hsiunglives alone in southern Taiwan.His wife died five years ago andhis four daughters all work andlive in far-off Taipei. Lai's favoritepastime is to go to the park nearby. I go there twice a day to do regularexercise and see old friends. Once you reach my age, you realize how importantold friends are since they're the ones that can quickly come to help you if you're in need," he says. "I would like to live with my daughters as, to tell you the truth, it's quite lonely living alone. But the thing is, I'm not accustomed to city life. Andyoung people have their own lives. But I am lucky because they provide me with money to cover my living expenses." according to a Ministry of the Interior (MOI) survey, 60.19 percent of the respondents

aged over 65 think the ideal way of living is to live with their children.

Lin, Zhang & Harwood 04: filial piety not absolute; applied out of sympathetic feeling

Liou (2007) on filial pietyFilial piety has been embedded in Chinese culture for thousand

years. Although author asserts that Taiwanese might have more filial support than China, it may not be appropriate to judge by the external side. In other words, in my opinion, filial support could not be judged only by the financial support or physical care and household support. The most important part in filial piety is the internal attitude. Whatever support you give your parents, you do it not because following the tradition or custom but because from your heart loving to do it. If someone just formally gives financial support to their parents and does not care their parents' feelings or never talks to them, his or her behavior cannot be regarded as a filial son or daughter. So if we want to fulfill this research, we have to do some further studies on quality analysis to embrace not only external changes but also internal attitude changes in family life.