Support and Care for Aging Chinese: A Comparison of Guangzhou, Hong Kong and Taipei

  • Daniel W. L. Lai


Chinese culture is renowned for its emphasis on respect for the older people. As a traditional virtue, filial piety is highly regarded in the Chinese culture. The social and moral obligation of “filial piety,” which carries the meanings of respect and providing support and care, continues to prevail. However, Chinese societies are not homogenous. Based on a large-scale comparative survey on health and well-being of older Chinese in Guangzhou, Hong Kong, and Taipei, this chapter examines the differences in social support and care received by older Chinese 65 years of age and older. The two research questions are (1) What are the levels of support and care received by the elderly Chinese in Guangzhou, Hong Kong, and Taipei? and (2) How does the support and care received differ for the elderly Chinese in these three locations? Similarities and differences among the older Chinese in these three locations are discussed, with focuses on living arrangements, social and financial support, care received for personal and instrumental care for activities of living, and perceived sense of loneliness. The sociocultural contexts in which these differences may be situated are also explained.


Social Support Family Support Chinese Culture Family Care Filial Piety 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Antonucci, T. C., Sherman, A. M., & Akiyama, H. (1996). Social networks, support, and integration. In J. E. Birred (Ed.), Encyclopedia of gerontology (Vol. 2, pp. 502–515). New York: Academic Press.Google Scholar
  2. Bajekal, M., Blane, D., Grewal, I., Karlsen, S., & Nazroo, J. (2004). Ethnic differences in influences on quality of life at older ages: A quantitative analysis. Ageing & Society, 24(5), 709–728.CrossRefGoogle Scholar
  3. Baorong, G., Pickard, J., & Jin, J. (2007). A cultural perspective on health outcomes of caregiving grandparents: Evidence from China. Journal of Intergenerational Relationships, 5(4), 25–40.Google Scholar
  4. Bosworth, H. B., & Schaie, K. W. (1997). The relationship of social environment, social networks, and health outcomes in the Seattle longitudinal study: Analytical approaches. Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 52B, 197–205.CrossRefGoogle Scholar
  5. Carstensen, L. L. (1991). Socioemotional selectivity theory: Social activity in life-span context. Annual Review of Gerontology and Geriatrics, 11, 195–217.Google Scholar
  6. Census & Statistics Department (2001). Hong Kong 2001 Population Census – Basic tables for district council districts (pp. 1–223). Hong Kong: Census & Statistics Department, Hong Kong Special Administrative Region, People’s Republic of China.Google Scholar
  7. Chan, A. (2005). Aging in Southeast and East Asian: Issues and policy directions. Journal of Cross-Cultural Gerontology, 20(4), 269–284.CrossRefGoogle Scholar
  8. Chao, S. Y., & Roth, P. (2000). The experiences of Taiwanese women caring for parents-in-law. Journal of Advanced Nursing, 31(3), 631–638.CrossRefGoogle Scholar
  9. Chau-Kiu, C., & Raymond, M. H. N. (2005). Improving old adults’ functional ability through service use in a home care program in Hong Kong. Research on Social Work Practice, 15(3), 154–164.CrossRefGoogle Scholar
  10. Chen, Y. J. (2007). More choices for families? Changing elderly care models in Taiwan. International Journal of Sociology of the Family, 33(1), 123–143.Google Scholar
  11. Cheng, S. T., & Chan, A. C. M. (2006). Filial piety and psychological well-being in well older Chinese. Journal of Gerontology, Psychological Sciences, 61, 262–269.CrossRefGoogle Scholar
  12. Chi, I., & Choi, K. L. (2001). Social support and depression among elderly Chinese people in Hong Kong. International Journal of Aging and Human Development, 52, 231–252.CrossRefGoogle Scholar
  13. Chiou, C. J., Chen, J. P., & Wang, H. H. (2005). Health status of family caregivers in Taiwan: An analysis of gender differences. International Journal of Geriatric Psychiatry, 20(9), 821–826.CrossRefGoogle Scholar
  14. Chiu, S., & Yu, S. (2001). An excess of culture: The myth of shared care in the Chinese community in Britain. Ageing & Society, 21(6), 681–699.CrossRefGoogle Scholar
  15. Chou, K. E., & Chi, I. (2001). Stressful life events and depressive symptoms: Social support and sense of control as mediators or moderators? International Journal of Aging and Human Development, 52, 155–171.CrossRefGoogle Scholar
  16. Chou, K. L., & Chi, I. (2004). Reciprocal relationship between pain and depression in elderly Chinese ­primary care patients. International Journal of Geriatric Psychiatry, 20, 945–952.CrossRefGoogle Scholar
  17. Chou, Y. C., Lee, Y. C., Lin, L. C., Chang, A. N., & Huang, W. Y. (2008). Social services utilization by adults with intellectual disabilities and their families. Social Science & Medicine, 66(12), 2474–2485.CrossRefGoogle Scholar
  18. Chow, N. W. S. (2001). The practice of filial piety among the Chinese in Hong Kong. In I. Chi, N. L. Chappell, & J. Lubben (Eds.), Elderly Chinese in Pacific Rim Countries. Hong Kong: Hong Kong University.Google Scholar
  19. Consedine, N. S., Magai, C., & King, A. R. (2004). Deconstructing positive affect in later life: A differential functionalist analysis of joy and interest. International Journal of Aging and Human Development, 58, 49–68.CrossRefGoogle Scholar
  20. Cooke, M. (2006). Policy changes and the labour force participation of older workers: Evidence from six countries. Canadian Journal on Aging, 25(4), 387–400.CrossRefGoogle Scholar
  21. Crouter, A. C., Bumpus, M. E., Head, M. R., & McHale, S. M. (2001). Implications of overwork and overload for the quality of men’s family relationships. Journal of Marriage & Family, 63(2), 404–417.CrossRefGoogle Scholar
  22. Cummings, S. M. (2003). The efficacy of an integrated group treatment program for depressed assisted living residents. Research on Social Work Practice, 13, 608–621.CrossRefGoogle Scholar
  23. Delgadillo, L., Sorensen, S., & Coster, D. C. (2004). An exploratory study of preparation for future care among older Latinos in Utah. Journal of Family and Economic Issues, 25(1), 51–78.CrossRefGoogle Scholar
  24. Delgado, M., & Tennstedt, S. (1997). Puerto Rican sons as primary caregivers of elder parents. Social Work, 42, 125–134.CrossRefGoogle Scholar
  25. Evashwick, C., & Ory, M. (2005). How to keep a public health and aging program going. Generations, 29(2), 76–81.Google Scholar
  26. Fong, S. L. M. (1973). Assimilation and changing social roles of Chinese Americans. Journal of Social Issues, 29(2), 115–127.CrossRefGoogle Scholar
  27. George, L. K. (2005). Stress and coping. In M. L. Johnson (Ed.), The Cambridge handbook of age and ageing (pp. 292–300). Cambridge: Cambridge University Press.Google Scholar
  28. Glaser, K., Stuchbury, R., Tomassini, C., & Askham, J. (2008). The long-term consequences of partnership dissolution for support in later life in the United Kingdom. Ageing & Society, 28(3), 329–351.CrossRefGoogle Scholar
  29. Gordon, M. (2001). Challenges of an aging population. Annals of the Royal College of Physicians and Surgeons of Canada, 34(5), 306–308.Google Scholar
  30. Gupta, R., & Pillai, V. K. (2000). Caregiver burden in South Asian families: A systems theory perspective. Journal of Ethnic and Cultural Diversity in Social Work, 9(1–2), 41–53.CrossRefGoogle Scholar
  31. Hashimoto, A., & Ikels, C. (2005). Filial piety in changing Asian societies. In M. L. Johnson (Ed.), The Cambridge handbook of age and ageing (pp. 437–442). Cambridge: Cambridge University Press.Google Scholar
  32. Health Canada. (2004). Family/Informal caregivers. Accessed 10 July 2008.
  33. Ho, D. Y. F. (1996). Filial piety and its psychological consequences. In M. H. Bond (Ed.), The handbook of Chinese psychology (pp. 155–165). Hong Kong: Oxford University Press.Google Scholar
  34. Holroyd, E. (2001). Hong Kong Chinese daughters’ intergenerational caregiving obligations: A cultural model approach. Social Science & Medicine, 53(9), 1125–1135.CrossRefGoogle Scholar
  35. Holroyd, E. E. (2003). Chinese family obligations toward chronically ill elderly members: Comparing caregivers in Beijing and Hong Kong. Qualitative Health Research, 13(3), 302–319.CrossRefGoogle Scholar
  36. Hui-Chuan, H. (2007). Exploring elderly people’s perspectives on successful ageing in Taiwan. Ageing & Society, 27(1), 87–102.CrossRefGoogle Scholar
  37. Ikegami, N. (1995). Functional assessment and its place in health care. New England Journal of Medicine, 332(9), 598–99.CrossRefGoogle Scholar
  38. Kahn, J. H., Hessling, R. M., & Russell, D. W. (2003). Social support, health, and well-being among the elderly: What is the role of negative affectivity? Personality and Individual Differences, 35, 5–17.CrossRefGoogle Scholar
  39. Keng-mun, L. W., & Kwok, H. K. (2004). Living arrangements and informal support for the elderly: Alteration to intergenerational relationships in Hong Kong. Journal of Intergenerational Relationships, 2(2), 27–50.CrossRefGoogle Scholar
  40. Keng-mun, L. W., & Kwok, H. K. (2005). Older women and family care in Hong Kong: Differences in filial expectation and practices. Journal of Women & Aging, 17(1/2), 129–150.Google Scholar
  41. Krause, N. (2001). Social support. In R. H. Binstock, L. K. George, V. W. Marshall, A. M. O’Rand, & J. H. Schultz (Eds.), Handbook of aging and the social sciences (pp. 272–294). San Diego: Academic Press.Google Scholar
  42. LaBauve, B. J., & Robinson, C. R. (1999). Adjusting to retirement: Considerations for counselors. Adultspan Journal, 1(1), 2–12.CrossRefGoogle Scholar
  43. Lam, C. W., & Boey, K. W. (2005). The psychological well-being of the Chinese elderly living in old urban areas of Hong Kong: A social perspective. Aging & Mental Health, 9(2), 162–166.CrossRefGoogle Scholar
  44. Lamberg, L. (2004). Impact of long working hours explored. Journal of the American Medical Association, 292(1), 25–26.CrossRefGoogle Scholar
  45. Lau, J. C. Y., & Chiu, C. H. (2004). Accessibility of workers in a compact city: The case of Hong Kong. Habitat International, 28(1), 89–103.CrossRefGoogle Scholar
  46. Leich, J. (2000). Preventing hospitalization home hospice nurses, caregivers, and shifting notions of the good death. Research in the Sociology of Health care, 18, 207–228.CrossRefGoogle Scholar
  47. Levande, D. I., Herrick, J. M., & Sung, K. (2000). Eldercare in the United States and South Korea. Journal of Family Issues, 21(5), 632–651.CrossRefGoogle Scholar
  48. Lowenstein, A., & Daatland, S. O. (2006). Filial norms and family support in a comparative cross-national context: Evidence from the OASIS study. Ageing & Society, 26(2), 203–223.CrossRefGoogle Scholar
  49. Magilvy, J. K., Congdon, J. G., & Martinez, R. (1994). Circles of care: Home care and community support for rural older adults. Advances in Nursing Science, 16(3), 22–33.Google Scholar
  50. Minnes, P., & Woodford, L. (2005). Well-being in aging parents caring for an adult with developmental disability. Journal on Developmental Disabilities, 11, 47–66.Google Scholar
  51. Ng, A. C. Y., Phillips, D. R., & Lee, W. K. M. (2002). Persistence and challenges to filial piety and informal support of older persons in a modern Chinese society: A case study in Tuen Mun, Hong Kong. Journal of Aging Studies, 16(2), 135–153.CrossRefGoogle Scholar
  52. North, R. J., Holahan, C. J., Moos, R. H., & Cronkite, R. C. (2008). Family support, family income, and happiness: A 10-year perspective. Journal of Family Psychology, 22(3), 475–483.CrossRefGoogle Scholar
  53. Ochocka, J., Nelson, G., Janzen, R., & Trainor, J. (2006). A longitudinal study of mental health consumer/survivor initiatives: Part 3 – A qualitative study of impacts of participation on new members. Journal of Community Psychology, 34(3), 273–283.CrossRefGoogle Scholar
  54. Ozawa, M. N., & Lum, T. Y. (2005). Men who work at age 70 or older. Journal of Gerontological Social Work, 45(4), 41–63.CrossRefGoogle Scholar
  55. Phelan, E. A., Anderson, L. A., LaCroiz, A. Z., & Larson, E. B. (2004). Older adults’ views of “successful aging” – How do they compare with researchers’ definitions? Journal of the American Geriatrics Society, 52(2), 211–216.CrossRefGoogle Scholar
  56. Philips, D. R., Siu, O. L., Yeh, A. G. O., & Cheng, K. H. C. (2008). Informal social support and older persons psychological well-being in Hong Kong. Journal of Cross Cultural Gerontology, 23, 39–55.CrossRefGoogle Scholar
  57. Porter, G. (2001). Workaholic tendencies and the high potential for stress among co-workers. International Journal of Stress Management, 8(2), 147–164.CrossRefGoogle Scholar
  58. Ren, X. S., & Chang, K. (1998). Evaluating health status of elderly Chinese in Boston. Journal of Clinical Epidemiology, 51, 429–435.CrossRefGoogle Scholar
  59. Ren, X. S., Amick, B., Zhou, L., & Gandek, B. (1998). Translation and psychometric evaluation of a Chinese version of the SF-36 Health Survey in the United States. Journal of Clinical Epidemiology, 51, 1129–1138.CrossRefGoogle Scholar
  60. Robertson, S. M., Zarit, S. H., Duncan, L. G., Rovine, M. J., & Femia, E. E. (2007). Family caregivers’ patterns of positive and negative affect. Family Relations, 56(1), 12–23.CrossRefGoogle Scholar
  61. Siebert, D. C., Multran, E. J., & Reitzes, D. C. (1999). Friendship and social support: The importance of role identity to aging adults. Social Work, 44, 522–533.CrossRefGoogle Scholar
  62. Siu, O. L., & Phillips, D. R. (2002). A study of family support, friendship, and psychological well-being among older women in Hong Kong. International Journal of Aging and Human Development, 55, 295–315.CrossRefGoogle Scholar
  63. Smith, A. E., Sim, J., Scharf, T., & Phillipson, C. (2004). Determinants of quality of life amongst older people in deprived neighbourhoods. Ageing & Society, 24, 793–814.CrossRefGoogle Scholar
  64. Stuifbergen, M. C., Van Delden, J. J. M., & Dykstra, P. A. (2008). Ageing & Society, 28(3), 413–434.CrossRefGoogle Scholar
  65. Sung, K. (2002). Filial piety: The East Asian ideal of parent care in changing times. Southwest Journal on Aging, 17(1–2), 23–29.Google Scholar
  66. Teri, L. (1999). Training families to provide care: Effects of people with dementia. International Journal of Geriatric Psychiatry, 14(2), 110–116.CrossRefGoogle Scholar
  67. Tracy, M. B. (1993). Government versus the family: The false dichotomy. Generations, 17(4), 47–51.Google Scholar
  68. Walker, A. J., Pratt, C. C., & Eddy, L. (1995). Informal caregiving to aging family members: A critical review. Family Relations, 44(4), 402–411.CrossRefGoogle Scholar
  69. Ware, J. E., Jr., & Gandek, B. (1998). Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. Journal of Clinical Epidemiology, 51, 903–912.CrossRefGoogle Scholar
  70. Ware, J. E., & Kosinski, M. (2001). Interpreting SF-36 summary health measures: A response. Quality of Life Research, 10, 405–413. 415–420.CrossRefGoogle Scholar
  71. Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–83.CrossRefGoogle Scholar
  72. Ware, J. E., Jr., Kosinski, M., Gandek, B., Aaronson, N. K., Apolone, G., Bech, P., et al. (1998). The factor structure of the SF-36 Health Survey in 10 countries: Results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51, 1159–1165.CrossRefGoogle Scholar
  73. Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical & mental health summary scales: A user’s manual. Boston: The Health Institute, New England Medical Centre.Google Scholar
  74. Westaway, M., Seager, J., Rheeder, P., & Van Zyl, D. (2005). The effects of social support on health, well-being and management of diabetes mellitus: A black South African perspective. Ethnicity & Health, 10(1), 73–89.CrossRefGoogle Scholar
  75. Wing, C. C. K. (1995). Love thy parents and care for thy children: Filial piety and intergenerational cooperation in traditional China. Journal of Socio-Economics, 24(2), 391–409.CrossRefGoogle Scholar
  76. Wong, O. M. H., & Chau, B. H. P. (2006). The evolving role of filial piety in eldercare in Hong Kong. Asian Journal of Social Science, 34(4), 600–617.CrossRefGoogle Scholar
  77. Wong, S. T., Yoo, G. J., & Stewart, A. I. (2007). An empirical evaluation of social support and psychological well-being in Older Chinese and Korean immigrants. Ethnicity & Health, 12, 43–67.CrossRefGoogle Scholar
  78. Yan, W. (2006). Value changes in an era of social transformation: College educated Chinese youth. Educational Studies, 32(2), 233–240.CrossRefGoogle Scholar
  79. Zhan, H. J. (2004). Through gendered lens: Explaining Chinese caregivers’ task performance and care reward. Journal of Women & Aging, 16(1/2), 123–142.CrossRefGoogle Scholar
  80. Zhan, H. J., & Montgomery, J. V. (2003). Gender and elder care in China: The influence of filial piety and structural constraints. Gender & Society, 17(2), 209–229.CrossRefGoogle Scholar
  81. Zhen, C. (2008). Intergenerational time-for-money exchanges in rural China: Does reciprocity reduce depressive symptoms of older grandparents? Research in Human Development, 5(1), 6–25.CrossRefGoogle Scholar
  82. Zheng, W., & Hart, R. (2002). The mental health of the childless elderly. Sociological Inquiry, 72(1), 21–42.CrossRefGoogle Scholar
  83. Zsembik, B. A., & Bonilla, Z. (2000). Eldercare and the changing family in Puerto Rico. Journal of Family Issues, 21(5), 653–674.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Faculty of Social Work, The University of CalgaryCalgaryCanada

Personalised recommendations