Filial piety Confucian familism with its special connection to the treatments of elderly people




Jin, Jiahui

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Against the backdrop of successful family planning in China, the aging of the society’s population is increasing. With the increasing number of older adults, the support of the elderly has become a significant issue for society. Filial piety and respect for the elderly are the fundamentals of Chinese society and its long history. One aspect of filial piety focused on the responsibilities of the family in eldercare. It advocates that the elderly need not only material help but also spiritual comfort and emotional support. This culture of filial piety in a traditional Chinese society illustrates a path for responding to problems of the aging population. However, with the advent of an industrialized society, China’s family structure has undergone fundamental changes. There is an increasing trend of families choosing to send the elders to long-term institutional care rather than home or community care. This has led to conflict between traditional filial piety principles and the new model of aging healthcare. As a result, it is important to understand whether the new institutional care in China will meet the material and spiritual needs of the elderly. This paper aims to examine how Chinese values connect with eldercare treatments nowadays with the interplay of filial piety Confucian familism. More specifically, this paper discusses how Confucian values play in the relationship among eldercare locations, accessibility to care, and how filial piety has been expressed in the senior home before and during the COVID-19 pandemic in China. Also, since the available data on service and quality in nursing homes in China is limited, it is important to understand what administrators and caregivers are experiencing as a first step. This paper examines the following issues during the COVID-19 outbreak. 1. To what extent does Filial-piety Confucian familism play a role in young and elder generation’s attitudes regarding elder health care? 2. What challenges do the nursing homes face before and during the pandemic? 3. How was filial-piety expressed in the nursing home before and during the pandemic? Methodology and Methods This project conducted a total of 15 in-depth interviews with selected interviewees, including both selected administrators and caregivers in five nursing homes in Shanghai, China. As the researcher was born and raised in Shanghai, the insights for this research came partially from the real-life experience and a personal understanding of Chinese culture. The researcher conducted this qualitative study in Shanghai during the time when there were restrictions on travel and interaction due to COVID-19. Regarding the location specialty, the researcher was able to conduct interviews in Shanghainese and observe the cultural rituals inherent in the region. The interviews were conducted to observe examples of experiences that administrators and caregivers observed or participated in. As such, the results are based on examples more so that opinions or attitudes. All interviews were recruited through email exchanges and discussions were over WeChat (a Chinese communication app) and phone calls due to the pandemic restrictions. Key Findings This study found that numerous young people in China chose to place their parents in nursing homes due to busy work schedules, house demolitions, and the need for long-term medical care for their parents. However, senior care institutions are still in the stage of exploration and standardization. Inevitably, there are some problems, including a shortage of professional medical staff and a limited level of medical services that can be provided. It was found that this new and flourishing model of elderly care is also facing a series of problems that are prevalent around the world, such as high bed vacancy rate, endless psychological problems of the elderlies, and increased operating costs of nursing homes. This information has led us to question whether the elders are living well and to try to understand views of nursing homes and filial piety. We found that most elders have gradually changed their traditional concept of filial piety to a more modern one. The administrators and caregivers we interviewed said that “filial piety” is a respect from the heart, a mutual emotional exchange and understanding. It possesses equality and democracy between two generations. Their comments suggest that more elderly people living in nursing homes have low attachment to traditional notions of filial piety. In contrast, more children have a solid attachment to traditional filial piety because they struggled mentally before sending their parents to a nursing home. In addition, the study found that filial piety was expressed differently before and during COVID-19. Prior to the pandemic, the administrators and caregivers suggested that individuals were more inclined to fulfill practical obligations and compassionate reverence needs. Whereas, during the pandemic, filial piety was expressed less practically and more emotionally due to the closure of institutions. Future Research Further studies should expand the sample size by including more nursing homes in various districts of Shanghai. It would be helpful if researchers can interview the caregivers and administrators in person and visit some of the care homes to gather other information on the unique needs of clients and families. Further studies could seek to discover how filial piety plays a role in the nursing home after the pandemic has passed. The challenges of the aging models can be further analyzed and recognized through exploring public policies and the needs of China’s overall society. For example, China's future pension system might need to respond to how filial piety evolves. A comprehensive pension security system based on current filial views could be established where children might play different roles in the older adults' material life, care, and spiritual comfort. This research offers suggestions to consider in future research relating to finding a role for elderly care homes in society in reducing some of the negative perceptions of these homes, developing a model that meets the needs of elderly and children, and training and developing staff. Firstly, research might seek to understand how to address some of the negative perceptions of the nursing homes and, possibly, change the view that nursing homes do not mean an abandonment of the elderly. Rather, research might seek to illustrate ways that nursing homes might implement a modern version of filial piety which provides a way that elderly can live in a care home as well as participating with their children in their family homes. Secondly, the study might get input into a template or model for designing nursing homes to recognize the evolving changes and pressures on traditional views of filial piety. As needs of children and elderly in a society have changed, so have their expectation of filial piety and, given these changes, how do we develop elderly institutions to respond to the economic needs of children and society at large? Thirdly, the research might investigate the response to the concerns raised from administrators about the shortage of trained staff. This might involve identifying needs of qualified care professional and encouraging their training and developing in colleges, vocational and technical colleges, secondary vocational schools, and county vocational education centers.



Filial Piety, Eldercare, Chinese Culture, Aging Population, Public Administration