Nursing home care for older people in Taiwan: a process of forced choice

Abstract

To generate a substantive theory for understanding the phenomenon of nursing home care for older people in Taiwan. Taiwanese culture shows great respect for older people and older people are traditionally cared for at home by their families. However, the older population in Taiwan is rapidly increasing and this demographic shift, together with various socio-economic changes, has resulted in nursing homes becoming a new and significant care option. A grounded theory approach was used to study the residents and relatives from three nursing homes in Taiwan. Formal and informal interviews and participant observation data were collected over two months in each nursing home. Forty nursing home residents and 20 of their relatives were recruited. The data were analysed using the constant comparative method and involved the use of theoretical memos and theoretical sampling procedures. The study found that nursing home care for older people in Taiwan is understood to be a process of forced choice, involving three stages; namely, 'becoming a problem', 'making a forced choice' and 'coping with the forced choice'. Taiwan is in a state of conflict with regard to providing care for older people, a situation in which the influence of traditional cultural and that of industrialization exist side by side. The consequence of having to relocate older people into nursing homes means that both parties are the victims of this choice. This conceptual explanation helps us to understand how the Taiwanese respond to the issue of care for older people and how they resolve their main concerns related to it. Subsequently, it is hoped that this will help health care practitioners to provide care more effectively to meet the needs of the Taiwanese with the aim of enhancing the standards of care for older people.