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