‘No matter if your son has the time or not, you still get sick’: understanding unmet healthcare needs among older people in China

Abstract

This study aimed to explore the experience of living with unmet healthcare needs and to understand the underlying mechanisms from the perspectives of older people and family caregivers in China. The study was nested within the 10/66 Dementia Research Group LIFE2YEARS project. We conducted in-depth interviews with 62 participants, using a narrative approach, and carried out thematic analysis. We found that older people’s experiences of unmet needs were inextricably linked to their relationships with their adult children and unfulfilled expectations of filial piety and familial support in older age. Older people desired both emotional and practical support from family members in relation to health and healthcare in order to support their navigation of health systems, which they perceived to be increasingly complex. Family support was the key means of support that older people looked to in order to address their needs for care, which were insufficiently met by the state. Unfortunately, at the same time that older people perceived the health system to be ever more impenetrable, there was a growing dislocation between their expectation of filial piety and the level of emotional, practical and financial support younger generations were able to provide. There is a need to develop community-based support to plug the gaps between what governments and families are able to provide.