Search Results (5)

Background: Although the application of smart home technology in the Chinese eldercare market is widespread, its effectiveness from the users’ perspective remains underexplored. This qualitative study examines the perceptions and experiences of older adult users in adopting and applying the Care-on-Call services (Ping An Tong; PAT), a prominent example of smart home technology for eldercare in Mainland China. Methods: Individual and dyadic interviews were conducted with 28 older adult users from diverse physical, socioeconomic, and familial backgrounds. Thematic analysis was performed. Results: Two overarching themes were illustrated based on thematic analysis. First, the multifaceted challenges of using PAT encompass an incomplete cognition of the services, unfamiliarity with PAT systems, psycho-cultural resistance, ‘do it yourself, don’t bother others’, economic concerns of additional costs, and ethical concerns regarding information security and privacy. Second, bridging the technology divide highlights the empowerment of PAT use among older adults through a variety of educational methods to effectively utilize the services, enhancing service effectiveness through the integration of smart home technology and social service provision, and increasing service accessibility through inclusive services. The disparities in smart home technology application between China and the West are also discussed. Conclusions: Psychosocial support, organizational programs, and the integrated service model are recommended to promote the utilization of smart home technology among older adults in China. Full article

Background: China’s rapidly aging population has increased the need for effective community-based eldercare services. However, the lack of standardized, culturally relevant evaluation frameworks hinders consistent service quality assessment and improvement. Objective: This systematic review aims to identify, synthesize, and critically evaluate the existing quality indicators (QIs) currently utilized for home-based community elderly care HCEC in China. It also aims to highlight gaps to inform the development of a more comprehensive and context-appropriate quality framework. Methods: Following PRISMA guidelines, systematic searches were conducted across Web of Science, PubMed, Wiley, and CNKI databases for studies published in English and Chinese from 2008 onward. Extracted QIs from eligible studies were categorized using Donabedian’s structure–process–outcome (SPO) model. Results: Fifteen studies met the inclusion criteria, with QI sets ranging from 5 to 64 indicators. Most studies emphasized structural and procedural aspects, while outcome measures were limited. Key gaps include inconsistent terminology, insufficient medical care integration, narrow stakeholder engagement, and limited cultural adaptation of Western theoretical frameworks. Furthermore, subjective weighting methods predominated, impacting indicator reliability. Conclusions: Currently, there is no formal quality framework to guide service providers in HCEC, and therefore, quality indicators can be described as fragmented and lack cultural specificity, medical integration, and methodological robustness. Future research should prioritize developing culturally anchored and medically comprehensive QI frameworks, standardize indicator terminology, actively involve diverse stakeholders through participatory methods, and adopt hybrid methodological approaches combining subjective expert insights and objective, data-driven techniques. Alignment with established international standards, such as the OECD long-term care quality indicators, is essential to enhance eldercare quality and support evidence-based policymaking. Full article

As China is transitioning to an aging society, the Chinese government has proposed an eldercare pattern, called medicalized elderly care, to help solve the rapid aging and health care problems together. However, the shortage of elderly caregivers is a critical issue, with deficiency both in quantity and quality. This study aims to survey nurses’ willingness to transition into medicalized elderly caregivers and compare it between modern and traditional regions. Nurses working in Guangdong (modern region) and Jilin (traditional region) were investigated using a self-administered questionnaire in October 2021. We analyzed the influencing factors through χ²-test, t-test a and binary logistic regression model and further explored the influence of region using propensity score matching (PSM). A total of 1227 nurses were included, with 726 (59.2%) of them showing willingness to transition. Nurses from traditional regions showed a significantly higher willingness to transition after PSM (p = 0.027). Other factors influencing nurses’ willingness were age, education, lived with older adults, participated in voluntary activities related to older adults, visited eldercare institutions, attitudes toward older adults, knowledge about older adults, hospice care attitudes and death attitudes. The willingness of nurses to transition was not high enough. To have more willing and skillful human resources for eldercare, we need a more “intimate society for older adults” in the first place. Full article

The paper investigates China’s effort to create an eldercare market to shed light on how China’s economic reform entailed the creation of new institutions (e.g., eldercare market including eldercare labour market) and the reconfiguration of existing institutions (e.g., governance and regulation, the family, and the community). All this was needed for the market to flourish while maintaining and strengthening the regime. An urban eldercare market, including an eldercare labour market, was created by local governments (i.e., municipalities, districts, counties, and towns) with central government policy directives, in order to address China’s demographic aging and care crisis. However, once enough demand and supply were created, local governments turned to New Public Management (NPM) to operate publicly funded eldercare institutions. The paper argues that NPM has different rationalities in China than in liberal democracies; in China, they strengthen the Party and contribute to the durability of the authoritarian rule, rather than “shrink the state”. However, in China as in the West, bureaucratic logic hampers the implementation of NPM and the governance of the eldercare sector. The implication of bureaucratic logic driving the regulation of the eldercare sector is that care is not at the centre of eldercare. The paper also argues that the commodification and privatization of eldercare, in line with the global trend, was a deliberate government policy aimed at creating a positive condition for the market economy to flourish, but at the expense of social reproduction/care. Unlike many Western transitions to market provision, this one entailed the decline in the extended family as the main eldercare institution of the immediate past. However, the commodification and privatization of social reproduction have been incomplete and met with resistance, prompting the state to invest more in the sector to maintain social stability. Data for this paper derive from personal interviews with key informants and eldercare workers, official document analysis, and secondary literature analysis from Chinese scholars in mainland China. Full article

This paper, drawn from a wider doctoral study that investigates how middle-class Chinese families manage and balance their resources to negotiate family duties across generations, focuses on the role of home ownership and property. The research considers intergenerational equity, which is a key part of social sustainability, and uses this to explore the shifting care expectations between generations and the inherent tensions between socioeconomic opportunities that have changed the shape of families and the belief in the importance of the family unit as a vehicle to deliver care. The research draws on the narratives of whole families in a ten-family study undertaken in the Chinese city of Tianjin. The findings reveal the critical role of housing resources in presenting alternative solutions to the performance of care. Firstly, the opportunity to make new choices in the face of shifting priorities across the life course is facilitated by property ownership. Secondly, it facilitates the possibility of living close by, but not together, maintaining the privacy of the nuclear family, but fulfilling care roles. Thirdly, housing resources promote variations on the traditional co-residence pattern for supporting frail elders and, finally, new forms of co-residences where care flows to the young family and their children. Full article