Ageing International

, Volume 41, Issue 4, pp 366–393 | Cite as

Ethnography of Eldercare by Elders in Shanghai, China



While existing media and policy discourse on aging and caregiving in China is dominated by attention to the burden of elder dependency, this article provides an ethnographic glimpse of the under-recognized role of older adults in providing informal care to the elderly in Chinese society today. The analysis is based on a quantitative survey and ethnographic fieldwork involving participant observation and interviews conducted in a residential area of Shanghai Municipality, the Chinese city with the highest degree of population aging in the nation. Conducted between 2010 and 2014, our research examined whether and how older adults in Shanghai can be considered as not just persons in need of care but also as active contributors of eldercare. While we observed senior aid to the aged occurring both within and outside family households in Shanghai, in this article we focus on elder caregiving within the context of the family, with particular attention to caregiving provided by elders’ spouses. Overall, we found that patterns of eldercare in Shanghai today are much more complex than public discourses dominated by the elder dependency concept might lead one to believe. Our study found that many older adult women and men in Shanghai are making significant contributions to eldercare in the form of both spousal mutual aid and spousal primary caregiving. We further found several ways in which the identification of a primary caregiver can be quite complicated in a methodological sense, whether in quantitative or qualitative research. We conclude that more careful scholarly and policy attention to older adults’ contributions is needed to better understand and address the challenges and potentials of China’s aging society.


China Eldercare Productive ageing Ethnography 



Support for this project was provided by a Fulbright China Studies Senior Scholars Research Award #1083 granted to the first author and by grants from the University of Vermont and Case Western Reserve University awarded to both authors. The project was facilitated by scholarly affiliation with the Fudan-Harvard Medical Anthropology Research Collaborative in the Sociology Department at Fudan University, and by logistical support by the Shanghai Xintu Center for Health Promotion. Special thanks are due to the first author’s host at Fudan University Dr. Tianshu Pan, to the Fudan University Medical Anthropology Master’s candidates Jinjin Feng, Yan Shen, and Ran Feng who provided research assistance, and to the numerous senior community volunteers who introduced us to family caregivers in their neighborhoods. A draft of this paper was presented by the first author at the Harvard Global Initiative on Caregiving for the Elderly (GICE) Workshop on Aging and Eldercare in Asia, organized by Arthur Kleinman, Ladson Hinton, and Hongtu Chen, in conjunction with the Asia Vision 21 Conference convened by the Fung Global Institute and the Harvard Asia Center in Hong Kong, May 2-4, 2014. A revised version was presented at the Society for East Asian Anthropology Conference in Hong Kong, May 19-22, 2016. Any errors or omissions are the authors’ alone.

Compliance with Ethical Standards

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. This research was approved by the Institutional Review Board of the University of Vermont and Case Western Reserve University.

Informed Consent

Informed consent was obtained from all individual participants included in the study. All names of research participants used in this article are pseudonyms.

Conflict of Interest

The authors declare that there is no conflict of interest.


  1. AARP (2011). Valuing the invaluable: 2011 update: The economic value of family caregiving. Resource document: AARP (formerly American Association for Retired Persons). Accessed 25 August 2015.
  2. Administration on Aging (2004). National family caregiver support program: Complete resource guide, Washington, D.C.: Administration on Aging.Google Scholar
  3. Banister, J., Bloom D. E., & Rosenberg, L. (2009). Population ageing and economic growth in China. Harvard University Program on the Global Demography of Aging: Working Paper Series. Accessed 2014 December 15.
  4. Baoshan Zhengdian News (保山整点新闻网) (2015). Attending to Tianjin Municipality’s 140,000 elders with dementia (关注津城14万名失能老人). Published 14 May. Accessed 29 August 2015.
  5. Beijing Evening News (2015). The 2015 development of the family report: Empty nest elderly comprise half of total elderly population (家庭发展报告:空巢老人占老年人总数一半). Published 13 May. Accessed 29 August 2015.
  6. Bourgeois, M. S. (2012). Skills training for spouses of patients with AD. Resource document: Rosalyn Carter International Caregiver Intervention Database. Accessed 30 November 2012.
  7. Braun, M., Scholz, U., Bailey, B., Perren, S., Hornung, R., & Martin, M. (2009). Dementia caregiving in spousal relationships: a dyadic perspective. Aging and Mental Health, 13(3), 426–36.CrossRefGoogle Scholar
  8. Central Committee of the Chinese Communist Party (CCCCP) (2006). Central Committee decision on the important issue of building a harmonious society (中央关于构建和谐社会若干重大问题决定). Promulgated at the 6th Plenary Session of the 16th National Congress of the CCCCP. Published 11 October. Accessed section 4, article 6 on 1 March 2015.
  9. Central Committee of the Chinese Communist Party (CCCCP) and the State Council (2000). CCCCP and State Council decision on strengthening work on aging (中共中央国务院关于加强老龄工作的决定). Published 19 August. Accessed 1 March 2015.
  10. Central Committee of the Chinese Communist Party (CCCCP) and the State Council (2011). CCCCP and State Council decision on strengthening work on aging (中共中央国务院关于加强老龄工作的决定). Published 28 December. Accessed 1 September 2015.
  11. Cheung, C.-K., & Kwan, A. Y. H. (2009). The erosion of filial piety by modernization in Chinese cities. Ageing and Society, 29(2), 179–98.CrossRefGoogle Scholar
  12. Fan, R. P. (2007). Which care, whose responsibility, and why family? A Confucian account of long term care. Journal of Medicine and Philosophy, 32(5), 495–517.Google Scholar
  13. Fang, Y. (方圆) (2012). China entering the depths of an aging society (中国步入“深度老龄化”社会). Article: China Net: Chinese Domestic Affairs (中国网中国国情). Published 11 July. Accessed 15 March 2013.
  14. Fishman, T. (2010). Shock of gray: The aging of the world’s population and how it pits young against old, child against parent, worker against boss, company against rival, and nation against nation. New York: Scribner.Google Scholar
  15. Gao, H. Q. (高辉清) (2009). Getting old before getting rich: A risk that we cannot afford (未富先老冒不起的险). Article: Scholarly Community (学者社区) Section of the China Review. Accessed 25 March 2013.
  16. Gao, Z. L. (高菊兰) (2010). The current eldercare situation in Shanghai: Experiences and challenges (上海老年人护理的现状,经验与挑战). In S.H. Lan and D.F. Lu (蓝淑慧,鲁道夫) (Eds.), Eldercare and long term care security: Case studies of models from China, Germany, and Japan (老年人护理与护理保险:中国,德国,和日本的模式几案例), (pp. 13-16). Shanghai: Shanghai Academy for Social Science Publishers (上海社会科学院出版社).Google Scholar
  17. Gaugler, J. E., Kane, R. L., & Kane, R. A. (2002). Family care for older adults with disabilities: Toward more targetable and interpretable research. International Journal of Aging and Human Development, 54(3), 205–231.Google Scholar
  18. Han, Y. (韩宇) (2012). How do we resolve the difficulty of China getting old before getting rich? (中国未富先老何以解困?). Article: Xinhua News Site (新化新闻新化网). Published 22 November. Accessed 15 March 2013.
  19. Hooyman, N., & Kiyak, H.A.S. (2011). Social gerontology: A multidisciplinary perspective. Pearson Education.Google Scholar
  20. Hua, F., & Di, X. (2002). Case study: China. In WHO (Ed.), Long-term care in developing countries: Ten case studies (pp. 1–44). Geneva: WHO.Google Scholar
  21. Ikels, C. (2004). Introduction. In C. Ikels (Ed.), Filial piety: Practice and discourse in contemporary China (pp. 1–15). Stanford: Stanford University Press.Google Scholar
  22. NAC (National Alliance for Caregiving), with AARP (2009). Caregiving in the U.S.: A focused look at those caring for someone age 50 or older: Executive summary. Accessed 3 March 2015.
  23. Newcomer, R. J., Kang, T., & Doty, P. (2012). Allowing spouses to be paid personal care providers: Spouse availability and effects on Medicaid-funded service use and expenditures. The Gerontologist, 52(4), 517–530.Google Scholar
  24. NHFPC (National Health and Family Planning Commission) (2015). Press release of the National Health and Family Planning Commission of the People’s Republic of China’s ‘Development of the family in China, 2015 Report' (国家卫生卫计委就《中国家庭发展报告(2015年)》举行发布会),” NHFPC (国家卫生卫计委). Published 13 May. Accessed 25 May 2015.
  25. O’Reilly, P. O., & Caro, F. G. (1995). Productive aging: an overview of the literature. Journal of Aging and Social Policy, 6(3), 39–71.CrossRefGoogle Scholar
  26. Schumpeter, J. (2010). The silver tsunami: Business will have to learn how to manage an ageing workforce. The Economist, 4 February.Google Scholar
  27. Senior Daily, Editor (2011). The number one family caregiver for urban elderly after spouses is daughters (城市家庭老人照顾者排名仅次于配偶的是女儿). Senior Daily (老年日报). Published 18 April. Accessed 25 August 2015.
  28. Shi, L. H. (2009). Little quilted vests to warm parents’ hearts”: Redefining the gendered practice of filial piety in rural north-eastern China. The China Quarterly, 2009(198), 348–363.Google Scholar
  29. Sokolovsky, J. (2009). The cultural context of aging: Worldwide perspectives. London: Praeger.Google Scholar
  30. Standing Committee of the National People’s Congress of the People’s Republic of China (2013). Law for the protection of elders' rights and interests (老年人权益保障法), Presidential Decree of the People’s Republic of China., promulgated 28 December 2012, in effect as of 1 July 2013. Accessed 1 March 2013.
  31. State Council of the People’s Republic of China (2006). Development of China’s undertakings for the aged (中国老龄事业的发展)., and, Published 12 December. Accessed 1 March 2013.
  32. State Council of the People’s Republic of China (2011). Development of China’s undertakings for the aged for the 12 th Five-Year Plan (中国老龄事业发展第“十二五”规划). 2011/content_1960671.htm. Published 2011. Accessed 1 March 2013.
  33. State Council of the People’s Republic of China (2016). Development of China’s undertakings for the aged for the 13 th Five-Year Plan (中国老龄事业发展第“十三五”规划). qcijepbkcdlechdlbk.html . Accessed 14 March 2016.
  34. Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Thousand Oaks: Sage.Google Scholar
  35. United Nations, Department of Economic and Social Affairs (2013). World population ageing. New York: United Nations, ST/ESA/SER.A/348, pp. 1–114.Google Scholar
  36. Wang, Q. (王琦), Managing Editor (2015). Development of the family in China report 2015: Half of the elderly are living in an empty nest (中国家庭发展报告2015》: 一半老人“空巢”生活). Changsha Evening News (长沙晚报). Published 14 May. Accessed 1 September 2015.
  37. WHO (World Health Organization) (2015). Definition of an older or elderly person, Accessed 1 September 2015.
  38. Xinhua (2016). Shanghai sees increasing aging population in 2015. Article: China Daily. Published 31 March. Accessed 25 May 2016.
  39. Yin, Z. G., and Zhou, H. W. (殷志刚,周海旺) (2014). Report on the situation of Shanghai Municipality’s elderly population and desire for development (上海市老年人口状况与意愿发展报告). Shanghai: Shanghai Academy of Social Sciences Press.Google Scholar
  40. Zhang, H. (2009). The new realities of aging in contemporary China: Coping with the decline in family care. In J. Sokolovsky (Ed.), The cultural context of aging: Worldwide perspectives (pp. 196–215). London: Praeger.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of AnthropologyUniversity of VermontBurlingtonUSA
  2. 2.Department of AnthropologyCase Western Reserve UniversityClevelandUSA

Personalised recommendations