The Nethersole School of Nursing The Chinese University of Hong Kong Engaging the Public: Local Strategies for Chinese elders Diana Lee Chair Professor of Nursing and Director

An Outline Successful aging – the literature Successful aging – views of Chinese elders Implications for local strategies to engage Chinese elders

Successful Aging – The Literature Factors associated with successful aging: physical and psycho-social indices Successful agers: -achievement of developmental tasks of later life -‘productive’ -functioning physically and psychosocially above ‘normal’

Cautionary Questions 1.Not adequately grounded in elderly people’s actual experiences and views. Some beginning work:  more emphasis on well-being and social functioning than physical and psycho- cognitive functioning  the ability to adjust to circumstances  focusing on gains rather than losses

Cautionary Questions Differences between elders’ and researchers’ perspectives on successful aging:  elders’ views: more multi-dimensional, less emphasis on functional aspects; sense of satisfaction and adjustment seen as more important (Phelan et al 2004)

Cautionary Questions Successful aging as a state of being  measured objectively by clinical standards vs Successful aging as a continuous adjustment process

Cautionary Questions 2. Socio-cultural considerations highly neglected  Existing knowledge on successful aging: a strong Western bias Individual accomplishment vs Collective orientation

Cautionary Questions Keith et al (1990): explore the aging experience of elders of different cultures  Americans: self-sufficiency, ability to live alone, how they view the world  Chinese: families’ willingness to meet their needs, how others view them

So…… Successful aging is a socially and culturally determined construction The need to develop understanding of the diversity and commonality of the aging experience across cultures  engage elders in culturally relevant interventions to promote successful aging

Successful Aging – Chinese Elders A grounded theory study on community Chinese elders in Hong Kong: Meaning of successful aging Being engaged in life - a life-course concept - active view of aging

Successful Aging – Chinese Elders Conditions of successful aging Harmonious family relation Independence in daily functioning and self- care within one’s physical ability Positive orientation to life in general and old age in particular Adequate social contact Sufficient financial resources

Successful Aging – Chinese Elders Strategies to age successfully Sustaining harmonious family relationship Striving to keep one’s physical, psychological and social health Influences of Chinese cultural beliefs Protecting the family’s face Maintaining harmony Being thankful

Implications “Go in search of people. Begin with what they know. Build on what they value.” Chinese proverb Engagement strategies should therefore  Focus on and result from the needs, expectations and desires of the Chinese elders

What to consider before starting the engagement effort? Elders’ previous life experiences and its impact on their engagement Life experiences in its totality Experiences of earlier life stages shape later life experiences

What is necessary for engagement to occur? Fitting into elders’ biography – A life-course approach Strengths and resources Physical, psychosocial and financial

What to consider for the engagement to be successful? Family-centred approaches/ strategies Focus on the family as a unit Promoting family responsibility Strengthening family action Creating a supportive environment for family growth and functioning

Re-orientation – Thinking and Practice A medical approach to needs assessment A biographical approach to understanding elders’ life experiences  elders’ psychosocial, cognitive and behavioural resources

Re-orientation – Thinking and Practice Individual/ personal ability and action Promoting, maintaining and restoring family functioning across life cycles