Microsoft Word - IkelsFINAL3 .docx Book Review Review of Evolving Eldercare in Contemporary China: Two Generations, One Decision. Lin Chen. Palgrave Macmillan. 2016. ISBN 978-1-137-54440-7. XVII-213. eBook. 76,99 Euros. Charlotte Ikels Case Western Reserve University (Professor of Anthropology Emerita) Anthropology & Aging, Vol 38, No 1 (2017), pp. 85-86 ISSN 2374-2267 (online) DOI 10.5195/aa.2017.164 This work is licensed under a Creative Commons Attribution 4.0 United States License. This journal is published by the University Library System of the University of Pittsburgh as part of its D-Scribe Digital Publishing Program, and is cosponsored by the University of Pittsburgh Press. Anthropology & Aging Vol 38, No 1 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.164 http://anthro-age.pitt.edu Ikels | Book Review 85 Book Review Review of Evolving Eldercare in Contemporary China: Two Generations, One Decision. Lin Chen. Palgrave Macmillan. 2016. ISBN 978-1-137-54440-7. XVII-213. eBook. 76,99 Euros. Charlotte Ikels Case Western Reserve University This phenomenological study was carried out in a large government-run facility for elderly in Shanghai and originally served as the basis for the author’s dissertation in social welfare. Shanghai leads China in the percentage of population aged 65 or above (25.7% in 2012) and thus can serve as a leader in the development of new forms of eldercare. Throughout the work the author refers to this facility as a nursing home even though it provides three levels of service including independent living, assisted living, and constant care. The participants in her study are drawn exclusively from the first two categories of care. While entrepreneurs have recently been investing in mega-retirement and continuing care communities, these cater only to the very wealthy. Smaller, private nursing homes have been around for 20 or more years with development especially rapid in the last decade. Even these homes are usually for-profit, beyond the financial reach of the majority of families, and offer very uneven service. Government-run facilities were originally intended as residences (“homes for the aged”) for older people without children or any means of support. In the 1990s under economic pressure government-run homes began to admit paying residents and to diversify their services by offering multiple levels of care. However, adult children and elders themselves had difficulty accepting the idea that elders with children could now live in such a government- run facility. Even with the family paying all the fees, separation of the generations seemed a violation of filial piety, of the debt that children owe their parents for bearing and rearing them. This book looks at how families come to make this difficult decision. To study this decision-making process Chen first introduces “crisis theory and how family caregiving crises may initiate the decision to institutionalize. Second, Chen defines intergenerational communication and identifies its potential impact…Third, Chen discusses uncertainty management theory to understand how each generation conceptualizes and manages the potential uncertainties of institutionalization. Fourth, Chen uses the life course perspective to situate the caregiving decision-making process in the context of both generations’ life courses” (p.41-2). Chapter 4 “Unexpected Reality: Etiology and Family Caregiving” and Chapter 5 “Intergenerational Negotiation: A Power Play” present the meat of the research. The organization of the book is problematic. The basic text extends to page 140. The remainder of the book consists of seven appendices including an extensive disquisition on phenomenology. Much of what the reader would want to know about the methodology (sample, instruments, analytical techniques) is hidden away here rather than in the body of the text. The sample of 12 dyads of elder and adult caregiving child are the survivors of the initial 20 residents whom the facility physician and staff social workers recommended. Sixteen of the 20 were formally consented, but when the researcher attempted to recruit their pre-institutionalization caregiving child, only 12 agreed to be interviewed. On average the interviews conducted between July and December of 2012 took Anthropology & Aging Vol 38, No 1 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.164 http://anthro-age.pitt.edu Ikels | Book Review 86 place more than three years after the decision to institutionalize had been made, thus, the study is retrospective not prospective and subject to the limitations of participants’ memories. One of the most interesting findings from this study is that the adult caregiving children, themselves – thanks to China’s only recently modified one child policy - largely parents of single children, are much more accepting of the on- going evolution in elder care. They have firsthand experience with the difficulties of family caregiving and do not expect to spend their last days in a family setting. Evolving Eldercare is a practice-oriented book. The author is particularly interested in enhancing intergenerational communication and understanding. In this study the author was struck by the disconnect between what adult children saw as their parents’ needs (instrumental care) and what the parents themselves saw as their needs (emotional support). She proposes that more research be directed to communication issues including that between front-line workers and the elderly in institutions.