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WHAT EXACTLY
ARE THE NEEDS?

Nurse and Patient on Wheelchair

THE
NEEDS

The Chinese have a culture that is devoted to family and respect for their elders, yet with an aging population there are barriers that interfere with the meaningful activities of their everyday life.

Population Assets:

Abolishment of the One Child Policy

The Chinese government abolished the One Child Policy in 2016 in an effort to increase the number of younger individuals that are able to care for the rapidly growing elderly population.

Filial Piety

The value of filial piety brings families closer together and focuses on the importance of caring for the elders as a means of showing respect.

Familial Bond

Family is a central focus in Chinese culture as a collective identity and positive reputation is of high importance to the family unit.

The Protection of the Rights and Interests of Elderly People

This law was put in place to protect the elderly and to keep the family involved in caring for the elderly. The government utilizes policies like this as a way of protecting and caring for the elderly population.

Colorful Buildings

Population Needs:

Social, Community, Friendships, & Family Participation

  • Education on senior urban community resources for displaced older individuals and establishment of new social connections

  • Education of opportunities for socially productive activities for individuals with an illness or disability in both the urban and rural setting

  • Help with redefining roles of elders experiencing care within the family

Increasing Assistance with ADLs

  • Provide training to caregivers on the safest and most effective ways to help care for their elders with respect to ADLs

  • Identification of resources such as home health aides who can provide care when caregiver is unavailable

  • Education on safe transfers and functional mobility

Leisure

  • Help identify interests and opportunities for leisure exploration and participation for the elder, but also help identify opportunities for the entire family to enjoy together.

Health Management & Maintenance

  • Assistance with accessing adequate healthcare and mental health services (especially in rural areas of China)

  • Establishing a health routine

  • Assistance with medication and nutrition management

  • Education of illness or disability of elder to family caregivers

  • Assistance with identifying resources for respite care

  • Provide health materials that those with low health literacy can understand

Safety & Emergency Maintenance

  • Education on resources that are available for elders who may be experiencing abuse or neglect 

  • Identification of emergency contacts and emergency response systems for isolated elders

  • Education on fall prevention

Work

  • Assistance with volunteer exploration and identification of resources, organizations, and opportunities for volunteering consistent with the individual’s skills and availability. This may help with reestablishing productivity and self-efficacy.

Perception of Aging and/or Disability with Respect to Culture

  • Help identify strengths of elder to help improve perception

Occupational Performance Issues:

Activities of Daily Living

Older Chinese individuals receiving care in the home setting may have difficulty with activities of daily living such as bathing, toileting, and dressing as a result of illness or disability and the inability of their caregiver to assist due to their absence because of work and other responsibilities or lack of knowledge. Additionally, these individuals often experience depression which can impact their interest in self-care, such as bathing regularly and/or wearing clean clothes. 

Financial Management

  • When they are neglected or do not have financial backing from their children, older Chinese often have to pay for medicines and healthcare. Older individuals, if they do have funds, do not always have control of or access to their money due to social hierarchy.

  • Despite aging and disabilities, some older adults still rely on labor intensive work for meager wages to support themselves financially. Financial self-dependency is a concern, especially for elders being neglected by caregivers. 

Sleep Preparation & Participation

The natural sleep pattern of older adults includes more light sleep and less deep sleep and sleep issues can be exacerbated by depression, anxiety, and the chronic illnesses such as heart disease and diabetes that this population may experience.

Community Participation

  • Participation in a variety of social activities for this population are impacted due to isolation resulting from illness or depression, feelings of inadequacy, and low energy. 

  • Lack of social participation may also be attributed to the older person not knowing the resources available in the new community. Connections with longtime friends for these displaced individuals may become weakened with time and distance. 

Family Participation

Participation in family activities may be filled with tension as a result of changing roles of the older parent from caregiver to care-receiver. Additionally, due to work and other responsibilities of the family caregivers, there may not be much opportunity to engage in activities that strengthen familial relationships.

Medication Management

Due to a variety of health-related issues, a majority of Chinese older adults require several pills to take several different times per day. Some older adults are unable to take all their medications properly without assistance and improper medication consumption can cause serious health repercussions.

Functional Mobility 

Older Chinese adults often live with medical conditions affecting their balance and strength. These challenges may impact safe transitions from one position or place to another during daily activities, such as in-bed mobility, wheelchair mobility, and transfers to and from a bed, shower, toilet or chair.

Health Management

  • Access to affordable healthcare is a concern despite social welfare programs. This is due in part to reliance on family caregivers and also due to social expectations of self-sufficiency.

  • Access and education about health and wellness is imperative for maintaining a healthy life. Older adults may not be aware of health resources and proper health management skills.

  • Mental health concerns include, but are not limited to increased depression and anxiety, among elderly adults. 

  • Older adults in China experience increased risk for certain physical health conditions. Certain behaviors and neglect can contribute to this risk. Physical health conditions increase likelihood of abuse by caregivers. 

(American Occupational Therapy Association, 2020)

Sociopolitical Considerations Impacting Occupational Performance:

The processes of modernization, urbanization, and industrialization have generated greater mobility of adult children from rural to urban settings in China, which in turn have altered changes in family structures and expected intergenerational filial support of older adults (Li et al., 2017). This has created changes in care for the aging population as the country looks to more facility options to care for the aging population and limited family members to care for the elderly. Health management becomes challenging as there are limited options currently for elderly care. 

Industrialization

Health Disparities

Areas in China without a strong public health infrastructure are associated with worse health in old age. In particular, using surface water instead of tap or underground water and using a toileting system without water may negatively affect health, including general health status and activities of daily living such as dressing, bathing, eating, and getting into or out of bed (Mather, 2020).

Social Credit Scores

The implementation of social credit scores affects how people interact with people and their environment. It has the ability to affect a lot of areas of occupation such as work and education participation, social participation, driving and community mobility, financial management, religious and spiritual expression, education and work opportunities.

(VICE News, 2018)

Resources:

In addition to China’s constitutional right to protection, China’s Anti-Domestic Violence Law of 2015 describes protection of elderly individuals. Government agencies are mandatory reporters of abuse and neglect which includes physical and/or psychological harm to individuals. Local governments are required to provide temporary shelters and resources for victims of reported abuse (Library of Congress, 2020). Reports can be made to China’s police by dialing 110, or through the Ministry of Health.  

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The National Health Commission of the People’s Republic of China offers information and expanded support services for the care of elders (China Daily, 2019). This government agency recognizes an increasing number of elderly who are not cared for by adult children and has expanded their resources for these elders. This expansion of support includes social welfare and policies such as a recent three child policy. This policy, though it may not be an economic solution, is a response to the aging population that resulted from the long term one child policy (Feng, 2021).

NHC.PNG

The National Health Commission of the People’s Republic of China offers support services for the care of elders.

Although living facilities for elders are relatively rare, there have been political efforts to de-stigmatize institutional and community-based living facilities for elderly and to provide resources for elders in their homes. Under government contract, the Virtual Elder Care Home, or Elder Care Home without Walls, provides in-home care services to the elderly, most of whom have no children to care for them (Feng et. al, 2020).

NHC2.PNG

The Elder Care Home without Walls provides in-home care services to the elderly.

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