Residential Care for Elderly People in Beijing, China: A Study of the Relationship between Health and Place

Abstract

This thesis is a study of the residential care for elderly people in Beijing, China. First, a set of statistical indicators are developed for mapping the spatial distribution of the elderly population and residential care facilities (RCFs). Secondly, in-depth, semi-structured interviews are used to understand the socio-cultural meanings of access, the decision making process in relocation, the well-being of elderly residents, as well as the challenges of residential care and social welfare reform. In total, 27 elderly residents, 16 family members, and five RCF managers were interviewed in six RCFs in Beijing. The constant comparative method is used to analyze all the transcribed interview materials. There are several major findings resulting from the research: the distribution of the elderly population and residential care resources is geographically uneven across the districts of Beijing and the supply of resources does not match the potential need. Elderly people and their family members choose residential care because of the shortage of community and home care resources and/or the advantages of residential care. The decision making process is a process of balancing geographical factors, quality of services, and financial affordability. Access to residential care is an interactive process influenced by geographical, economic, and social-cultural factors. The physical and socio-cultural environments of RCFs and individual’s sense of place play important roles in their adaptation and well-being after the relocation from the home to a RCF. Building up the active aging model with joint efforts from governments, society, RCFs, and individuals is helpful and effective for promoting the well-being of elderly residents in RCFs. At the end, the study also provides suggestions for the government, organizations, and RCFs on aspects such as administration, policy making, planning, volunteering, and management of RCFs to meet the challenges of residential care in China. The study confirms the importance of healthy living environments to the well-being of elderly residents. It also provides knowledge for understanding the reconfiguration of filial piety in decision making processes and utilization of residential care in current Chinese society. From a health geography perspective, this thesis is one of the first studies on residential care in China.