Debating “Good” Care: The Challenges of Dementia Care in Shanghai, China

Yan Zhang

doi:10.5195/aa.2020.266

Abstract

The increasing number of dementia sufferers in China has transformed dementia care from a private issue to a public concern. Nationwide dementia-friendly campaigns have intensified debates about what constitutes “good” care. In response to these campaigns, the Shanghai government proposes a systematic care model, which stresses the need for dementia-care units and professionalization. Non-state actors, however, focus on the relational care model, which integrates western humanitarian ethics with Confucian values. This article employs cultural and structural frameworks to examine why and how a specific form of “good” care is constructed in China. The debates about the establishment of dementia-care units and the professionalization of eldercare enable us to understand how politics shape certain forms of care.

Highlights

IntroductionIn order to avoid stigma, domestic settings become the primary sphere for dementia sufferers
Dementia-friendly campaigns recently initiated by different stakeholders are changing the landscape of eldercare in China (Zhang, forthcoming)
In the systematic care model, the state possesses the authority to establish social policies and laws. This form of care has been implemented through the construction of dementia-care units and the professionalization of dementia care services, especially the standardized training of nursing aides

Summary

Introduction

In order to avoid stigma, domestic settings become the primary sphere for dementia sufferers Social services, such as nursing homes and community-based programs supporting patients and their families, are underdeveloped. For a variety of reasons, advocates on behalf of dementia sufferers and their families frame their arguments about “good” care within the context of Western humanitarian ethics They propose that elders with dementia should have equal access to institutional, community-based, and in-home care. The difference is that relational care—with an emphasis on ren in China—is more about a paradigm than relationships between caregivers and recipients Building on both Confucian ethics and Western humanitarian care ethics, this type of care values social inclusiveness, genuine respect and support for elders, and the family-like culture in institutions. Systematic care and relational care often coexist in eldercare facilities, which can create conflicts and resistance between state and non-state actors regarding how to provide “good” care

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Conclusion