Social construction of Taiwanese intergenerational caregiving in families with frail older people

Submission note: A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Nursing, Faculty of Health Sciences, La Trobe University, Bundoora.

This doctoral study explored the experiences of intergenerational caregiving in Taiwanese families with frail older people. Using a case study methodology twelve families were recruited through community services in southern and northern Taiwan. A total of 32 family members across three generations agreed to participate in the study. This included the care recipient and caregivers: 11 frail older people, 3 spouse caregivers, 10 adult child caregivers and 8 grandchildren. Data collection methods included: individual semi-structured interviews, socio-demographic survey and ecomaps that mapped individual participant’s support networks. A grounded theory approach to data analysis was used. The theoretical lens of social constructionism was used to examine how sociocultural contexts constructed intergenerational caregiving. Evidence from this study revealed that the meaningful reality of intergenerational caregiving was a product of social construction. At a micro level intergenerational caregiving was shaped by interactions between people in their social world that were dictated by cultural norms and social structures at a macro level. Taiwanese intergenerational caregiving was a construction of searching for normality in everyday life. With the older person’s increasing frailty, families needed to decide who, how and where care would be provided. This life changing event disrupted established family routines and created a physical and psychosocial burden for caregivers. Tensions arose in interpersonal relationships within and across generations as traditional and emerging new sociocultural norms collided. Families, therefore, needed to reframe the way they lived through a variety of behaviour-focused and cognitive strategies. Formal health care services constructed by experts contributed little to assist families in their struggle to maintain normality. If families are to continue to care for their frail older person as expected by government, health professionals and the Taiwanese community changes to policy and health professional practice are required.