‘I try my best … I try to relieve the burden of my mum’: a narrative analysis of the everyday care-giving experiences for five intergenerational Singapore-Chinese families where one member has dementia

Abstract

Singapore is experiencing a rapid growth in its ageing population with most of the islands’ inhabitants living in high-rise apartments due to the scarcity of land. The Chinese community living in Singapore comprises the largest ethnic group and they are more likely to live together under one roof in an intergenerational family grouping. Currently, there are gaps in understanding intergenerational Singapore-Chinese families and their approach to caring at home for a family member with dementia. The aim of this longitudinal qualitative study was to understand better this everyday care-giving experience. Using semi-structured biographical interviews and digital photographs to elicit family stories, five intergenerational Singapore-Chinese families were visited at home for a period of between six and 15 months. Each recruited intergenerational family was treated as a ‘case’. Narrative analysis of the data was applied within and between cases and resulted in the emergence of three themes that represented various dynamics in the data. The three themes were identified as: (1) family values, which is about the cultural context in which everyday care takes place, the religious beliefs and practices of the intergenerational Singapore-Chinese families, and the practice of filial piety; (2) family support, which is about everyday access to family and service networks, including the contribution of the live-in maid in caring for the family member with dementia; and (3) family bonds, which is about the maintenance of intergenerational family relations in the Chinese family kinship system.

The Understanding and Experiences of Living with Dementia in Chinese New Zealanders

“…Our findings that Chinese families have an obligation to care for their elders with dementia and the practicing of filial piety are consistent with international literature [21][22][23][24][25]. Indeed, Chinese Canadian dementia carers felt taking care of their parents was more than a responsibility; "it was the way of life" [23].…”

“…They also lived with worries and emotional struggles and their needs were often shaped by their traditional beliefs [23]. A study of Singapore-Chinese dementia carers found that intergenerational connection and closeness are one of the important Chinese family values [25]. Previous Australian studies have suggested that Chinese communities prefer to provide dementia care at home (including day activities, community nursing and home help), rather than nursing home care [21,26].…”

The experiences of East Asian dementia caregivers in filial culture: a systematic review and meta-analysis

“…Several studies highlighted that recognizing and adhering to filial culture among East Asian dementia CGs was common (35,50,53,54,56). For example, in a study by Koo (50), Chinese Singaporean CGs demonstrated deep filial piety and reciprocity for the following reasons: repayment for their parents' care, practicing a religious faith, and having a Chinese identity.…”

“…Several studies explored the impact of filial culture on the role transition of dementia CGs (35,50,(53)(54)(55)(56). In East Asia, filial piety is a cultural belief in which participants assume the caregiving role when their family member becomes impaired and needs assistance.…”

“…Acceptance of this social norm seems to be the most common reason that participants become family CGs (35,54,55) and accept their caregiving role (54). In the cycle of filial piety, the relationship between aging parents and their children changes from "parents protecting children" to "children becoming the guardians of their parents" (50). In some East Asian countries, caring for aging parents has even become a legal obligation emphasizing the moral duties of children.…”