Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T00:47:30.812Z Has data issue: false hasContentIssue false
  • English
  • Français

‘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

Published online by Cambridge University Press:  14 February 2020

May Yeok Koo Open the ORCID record for May Yeok Koo [Opens in a new window] ,
Helen Pusey  and
John Keady
May Yeok Koo*
Affiliation:
School of Health and Social Sciences, Nanyang Polytechnic, Singapore, Republic of Singapore
Helen Pusey
Affiliation:
Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
John Keady
Affiliation:
Division of Nursing, Midwifery and Social Work, The University of Manchester/Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Type
Article
Information
Ageing & Society , Volume 41 , Issue 8 , August 2021 , pp. 1897 - 1919
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Attar-Schwartz, S, Tan, JP and Buchanan, A (2009) Adolescents’ perspectives on relationships with grandparents: the contribution of adolescent, grandparent, and parent–grandparent relationship variables. Children and Youth Services Review 31, 1057–1066.CrossRefGoogle Scholar
Beach, DL (1997) Family caregiving: the positive impact on adolescent relationships. The Gerontologist 37, 233–238.CrossRefGoogle ScholarPubMed
Blanton, PW (2013) Family caregiving to frail elders: experiences of young adult grandchildren as auxiliary caregivers. Journal of Intergenerational Relationships 11, 18–31.CrossRefGoogle Scholar
Boughtwood, DL, Adams, J, Shanley, C, Santalucia, Y and Kyriazopoulos, H (2011) Experiences and perceptions of culturally and linguistically diverse family carers of people with dementia. American Journal of Alzheimer's Disease & Other Dementias 26, 290–297.CrossRefGoogle ScholarPubMed
Celdrán, M, Triadó, C and Villar, F (2011) ‘My grandparent has dementia’: how adolescents perceive their relationship with grandparents with a cognitive impairment. Journal of Applied Gerontology 30, 332–352.CrossRefGoogle Scholar
Celdrán, M, Villar, F and Triadó, C (2012) When grandparents have dementia: effects on their grandchildren's family relationships. Journal of Family Issues 33, 1218–1239.CrossRefGoogle Scholar
Celdrán, M, Villar, F and Triadó, C (2014) Thinking about my grandparent: how dementia influences adolescent grandchildren's perceptions of their grandparents. Journal of Aging Studies 29, 1–8.CrossRefGoogle ScholarPubMed
Charon, R (2008) Narrative Medicine: Honoring the Stories of Illness. New York, NY: Oxford University Press.Google Scholar
Dai, Y and Dimond, MF (1998) Filial piety: a cross-cultural comparison and its implications for the well-being of older parents. Journal of Gerontological Nursing 24, 13–18.CrossRefGoogle ScholarPubMed
Grøndahl, VA, Persenius, M, Bååth, C and Helgesen, AK (2017) The use of life stories and its influence on persons with dementia, their relatives and staff – a systematic mixed studies review. BMC Nursing 16, 28.CrossRefGoogle Scholar
Ha, NHL, Chong, MS, Choo, RWM, Tam, WJ and Yap, PLK (2018) Caregiving burden in foreign domestic workers caring for frail older adults in Singapore. International Psychogeriatrics 30, 1139–1147.CrossRefGoogle Scholar
Hamill, SB (2012) Caring for grandparents with Alzheimer's disease: help from the ‘forgotten’ generation. Journal of Family Issues 33, 1195–1217.CrossRefGoogle Scholar
Hinton, L, Nhauyen Tran, J, Tran, C and Hinton, D (2008) Religious and spiritual dimensions of the Vietnamese dementia caregiving experience. Hallym International Journal of Aging 10, 139–160.CrossRefGoogle ScholarPubMed
Hsueh, KH (2001) Family Caregiving Experience and Health Status Among Chinese in the United States (PhD dissertation). Ann Arbor, MI: UMI Dissertation Services, ProQuest Information and Learning.Google Scholar
Gerdner, LA, Tripp-Reimer, T and Simpson, HC (2007) Hard lives, God's help, and struggling through: caregiving in Arkansas Delta. Journal of Cross-cultural Gerontology 22, 4, 355–374.CrossRefGoogle ScholarPubMed
Ho, B, Friedland, J, Rappolt, S and Noh, S (2003) Caregiving for relatives with Alzheimer's disease: feelings of Chinese-Canadian women. Journal of Aging Studies 17, 301–321.CrossRefGoogle Scholar
Innes, A, Abela, A and Scerri, C (2011) The organisation of dementia care by families in Malta: the experiences of family caregivers. Dementia: The International Journal of Social Research and Practice 10, 165–184.CrossRefGoogle Scholar
Jordan, DK (1986) Folk filial piety in Taiwan: the twenty-four filial exemplars. In Slote, WH (ed.), The Psycho-cultural Dynamics of the Confucian Family: Past and Present. Seoul: International Cultural Society of Korea, pp. 47–106.Google Scholar
Keady, J (1996) The experience of dementia: a review of the literature and implications for nursing practice. Journal of Clinical Nursing 5, 275–288.CrossRefGoogle ScholarPubMed
Keady, J, Williams, S and Hughes-Roberts, J (2007) ‘Making mistakes’: using co-constructed inquiry to illuminate meaning and relationships in the early adjustment to Alzheimer's disease: a single case study approach. Dementia: The International Journal of Social Research and Practice 6, 343–364.CrossRefGoogle Scholar
Kindell, J, Burrow, S, Wilkinson, R and Keady, JD (2014) Life story resources in dementia care: a review. Quality in Ageing and Older Adults 15, 151–161.CrossRefGoogle ScholarPubMed
Koo, MY and Pusey, H (2018) Photography and case study interviewing to document intergenerational family care in Singapore-Chinese families where one member is living with dementia. In Keady, J, Hyden, L-C, Johnson, A and Swarbrick, C (eds), Social Research Methods in Dementia Studies: Inclusion and Innovation. London: Routledge, pp. 140–168.Google Scholar
Mehta, KK (2006) A critical review of Singapore's policies aimed at supporting families caring for older members. Journal of Aging & Social Policy 18, 43–57.CrossRefGoogle ScholarPubMed
Miahouakana Matondo, JP (2012) Cross-cultural values comparison between Chinese and sub-Saharan Africans. International Journal of Business and Social Science 3, 38–45.Google Scholar
Milne, A and Chryssanthopoulou, C (2005) Dementia care-giving in Black and Asian populations: reviewing and refining the research agenda. Journal of Community and Applied Social Psychology 15, 319–337.CrossRefGoogle Scholar
Napoles, AM, Chadiha, L, Eversley, R and Moreno-John, G (2010) Reviews: Developing culturally sensitive dementia caregiver interventions: are we there yet? American Journal of Alzheimer's Disease & Other Dementias 25, 389–406.CrossRefGoogle ScholarPubMed
Netto, NR, Goh, YNJ and Yap, LKP (2009) Growing and gaining through caring for a loved one with dementia. Dementia: The International Journal of Social Research and Practice 8, 245–261.CrossRefGoogle Scholar
Novy, C (2018) Life stories and their performance in dementia care. The Arts in Psychotherapy 57, 95–101.CrossRefGoogle Scholar
Radley, A and Chamberlain, K (2001) Health psychology and the study of the case: from method to analytic concern. Social Science and Medicine 53, 321–332.CrossRefGoogle Scholar
Riessman, CK (2008) Narrative Methods for the Human Sciences. Thousand Oaks, CA: Sage.Google Scholar
Roach, P, Keady, J, Bee, P and Williams, S (2014) ‘We can't keep going on like this’: identifying family storylines in young onset dementia. Ageing & Society 34, 1397–1426.CrossRefGoogle Scholar
Rolland, JS (2012) Mastering family challenges in serious illness and disability. In Walsh, F (ed.), Normal Family Processes, 4th Edn. New York, NY: Guilford Press, pp. 452–482.Google Scholar
Seow, D and Yap, PLK (2011) Family caregivers and caregiving in dementia. The Singapore Family Physician 137, supplement 1, 24–29.Google Scholar
Sherman, CW and Boss, P (2007) Spousal dementia caregiving in the context of late-life remarriage. Dementia: The International Journal of Social Research and Practice 6, 245–270.CrossRefGoogle Scholar
Sheu, S (1997) Filial Piety (Hsiao) and Filial Caregiving Experiences of Chinese Families in the San Francisco Bay Area (Unpublished manuscript). University of California, San Francisco.Google Scholar
Singapore Department of Statistics (2009) General Household Survey 2005 Statistical Release 1: Socio-demographic and Economic Characteristics. Available at http://www.singstat.gov.sg/pubn/popn/ghsr1.html.Google Scholar
Singapore Department of Statistics (2012) Singapore in Figures 2012. Available at www.singstst.go.sg.Google Scholar
Singapore Department of Statistics (2018) Population Trends 2016. Available at www.singstat.gov.sg.Google Scholar
Singapore Government (2018) Singapore Status Online Plus. Maintenance of Parents Act (Chapter 167B). Available at https://sso.agc.gov.sg/Act/MPA1995.Google Scholar
Smith, HJ, Chen, J and Liu, X (2008) Language and rigour in qualitative research: problems and principles in analyzing data collected in Mandarin. BMC Medical Research Methodology 8, 1–8.CrossRefGoogle ScholarPubMed
Subramaniam, M, Chong, SA, Vaingankar, JA, Abdin, E, Chua, BY, Chua, HC, Eng, GK, Heng, D, Hia, SB, Huang, W, Jeyagurunathana, A, Kua, J, Lee, SP, Mahendran, R, Magadi, H, Malladi, S, Mccrone, P, Pang, S, Picco, L, Sagayadevan, V, Sambasivam, R, Seng, KH, Seow, E, Shafie, S, Shahwan, S, Tan, LL, Yap, M, Zhang, Y, Ng, LL and Prince, M (2015) Prevalence of dementia in people aged 60 years and above: results from the WiSE study. Journal of Alzheimer's Disease 45, 1127–1138.CrossRefGoogle ScholarPubMed
Sung, KT (1998) An exploration of actions of filial piety. Journal of Aging Studies 12, 369–387.CrossRefGoogle Scholar
Szinovacz, ME (2003) Caring for a demented relative at home: effects on parent–adolescent relationships and family dynamics. Journal of Aging Studies 17, 445–472.CrossRefGoogle Scholar
Tam, WJ, Koh, GC, Legido-Quigley, H, Ha, NHL and Yap, PLK (2018) ‘I can't do this alone’: a study on foreign domestic workers providing long-term care for frail seniors at home. International Psychogeriatrics 30, 1269–1277.CrossRefGoogle Scholar
Teo, P, Mehta, K, Thang, LL and Chan, A (2006) Ageing in Singapore: Service Needs and the State. London: Routledge.CrossRefGoogle Scholar
Tew, CW, Tan, LF, Luo, N, Ng, WY and Yap, P (2010) Why family caregivers choose to institutionalize a loved one with dementia: a Singapore perspective. Dementia and Geriatric Cognitive Disorders 30, 509–516.CrossRefGoogle ScholarPubMed
Thang, LL and Mehta, KK (2009) The dynamics of multigenerational care in Singapore. Paper presented at the Seminar on Family Support Networks and Population Ageing, Doha, Qatar, June.Google Scholar
United Nations (2017) World Population Ageing – Highlights. United Nations Department of Economic and Social Affairs. Available at https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Highlights.pdf.Google Scholar
Walker, AJ, Shin, H and Bird, DN (1990) Perceptions of relationship change and caregiver satisfaction. Family Relations 39, 147–152.CrossRefGoogle Scholar
Yap, P and Seng, BK (2009) Profiling the Dementia Family Carer in Singapore. Available at http://www.alz.org.sg/about-dementia/publications.Google Scholar
Yeon, KC and Levkoff, SE (2001) Culture and dementia: accounts by family caregivers and health professionals for dementia-affected elders in South Korea. Journal of Cross-cultural Gerontology 16, 111–125.Google Scholar
Yin, RK (2009) Case Study Research: Design and Methods, 4th Edn. Thousand Oaks, CA: Sage.Google Scholar