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An Ambiguous Sense of Professional Identity: Community-Based Caregivers for Older Adults in China

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Abstract

Community-based caregivers form an important part of the long-term care system in China. Rather than institutionalization in residential facilities, the majority of older adults in China continue to live with their families and in their communities; ageing-in-place is the norm. The services provided by community-based caregivers thus play a crucial role in shaping the quality of life for older adults in China. Yet this population of caregivers has been understudied, with most researchers and policymakers focusing instead on familial or institutional care providers. Our qualitative study addresses this gap by examining the experiences of community-based eldercare providers in urban Shanghai, one of the most rapidly-aging cities in China. Over 25 h of semi-structured, in-depth interviews and focus group discussions were conducted among 20 community-based caregivers. Our study revealed important demographic characteristics and trends in the experiences of this understudied population of caregivers, who were often confused about their jobs and demonstrated an ambiguous sense of professional identity. We provide a typology of the main factors influencing the experiences of community-based caregivers for older adults. This typology enables us to provide targeted suggestions to improve the work experiences and develop the sense of professional identity among community-based caregivers. We also present suggestions for strengthening the long-term care system for older adults in urban China.

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Notes

  1. The city region of Shanghai is divided into different geographic districts—smaller municipal administrative units and independent living compounds—according to the ‘city-district-street-neighborhood’ hierarchy (Xu et al. 2005, p.80). The street office (jiedao) is the street-level administrative authority that implements policies and programs. The tangible community area at the street level is thus the basic administrative governance unit (Xu et al. 2005). It includes many neighborhoods that differ in size and complexity of social phenomena and in relation to the ecological structure of the larger community as a ‘unified, organic whole’ (Agrawal and Gibson 1999). Services currently rendered by the community are most restricted in terms of offering fundamental help to the elderly.

  2. Care person, in Chinese关爱员 ( Guan Ai Yuan) is the name or proxy for people called by the community administrative organs. Its literal meaning is: people who bring care and love.

  3. There is no adoption relationship between the elderly and the caregiver. The terms simply express feelings of closeness between the two parties.

  4. See footnote 2 in previous text.

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Acknowledgments

The study is supported by the following grant agencies: China National Social Science Foundation (“Intergenerational Equilibrium and Multi-Governance: Research on the Social Support System in China’s Ageing Society”, project no. 71490733) and Washington University Harvey A. Friedman Center for Aging (Global Aging Initiative Award).

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Authors and Affiliations

  1. Department of Social Work, School of Social Development and Public Policy, Fudan University, Shanghai, China

    Honglin Chen & Lu Wang

  2. Department of Sociology, Faculty of Ethnology and Sociology, Minzu University of China, Beijing, China

    Hui Yang

  3. Department of Anthropology, Faculty of Arts and Sciences, Washington University, St. Louis, MO, USA

    Priscilla Song

Authors
  1. Honglin Chen
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  2. Hui Yang
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  3. Priscilla Song
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  4. Lu Wang
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Correspondence to Honglin Chen.

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The authors declare that there is no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Ethical Treatment of Experimental Subjects (Animal and Human)

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Honglin Chen, Hui Yang, Priscilla Song and Lu Wang are co-first authors.

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Chen, H., Yang, H., Song, P. et al. An Ambiguous Sense of Professional Identity: Community-Based Caregivers for Older Adults in China. Ageing Int 42, 236–250 (2017). https://doi.org/10.1007/s12126-016-9266-2

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