Pathway III

The third approach represented two cases. Management, formal activities, and friendship

were absent in this pathway (see Figure 3). This indicated a weak supporting condition for both institutional and social aspects. Care, hobby, and freedom were three key determinants in this configuration leading to the outcome of home. And the attributes of filial and optimism were found to be substitutive of each other, and also compensated for one another’s absence. This combination of conditions suggested that either supports from one’s inner strength or from family members could be sufficient to promote the feeling of home when they jointly functioned with the three core attributes.

This pathway was demonstrated by 85-year-old resident Mr. Han, who has lived in a small facility for a half year. He moved into the elder care home because he could not bear the burden of taking care of his son any longer. Mr. Han’s son was not a filial child according to Chinese culture standards. The son did not have a stable job but had a habit of high consumption. Mr. Han had to do the housework and cooking and spent his entire retirement pension on his son. To rectify this situation, Mr. Han decided to move into an elder care home. This facility was small, offering services to fewer than 60 older persons. The majority of residents had cognitive or physical impairments. Mr. Han was one of the few residents who were able to take care of themselves.

Because of the facility’s size and the need of extensive care for most residents, there were not many activities available. Instead of making friends within the institution, Mr. Han went to a park near the facility to exercise and socialize. When asked why he chose this small facility, he replied,

The good thing [about the facility] is that there is a park on the east side of the facility. The distance is about 500 meters, just one stop by bus…I like to exercise. When I exercise in the park, I make friends and stop for a chat. I feel good about [this lifestyle], ease of mind. Mr. Han developed a stable life routine. He went to exercise in the morning and rested in the afternoon. Although he had unpleasant experiences with children, he was content about his current lifestyle because he was free to do activities that please only him. The lack of activities and friendship within the facility seemed to be irrelevant to Mr. Han, since he was able to find alternative sources to compensate for his social needs. The only concern that Mr. Han had in regard to the facility was the constant increase in monthly fees. Mr. Han preferred to age in the facility if the facility would stop increasing their fees. Otherwise, he might be forced to find an

alternative place. Nevertheless, without considering the future, Mr. Han indicated that he still considered the facility as his home because he enjoyed his life at the moment.

Another participant, Mrs. Xu, lived in a medium facility for approximately 9 months. In her experiences with the residential care environment, Mrs. Xu expressed satisfaction with its care services, and she was able to continue her hobby of exercising. After moving into the facility, Mrs. Xu kept her previous lifestyle of living alone. In Mrs. Xu’s view, geographical separation from children did not affect their emotional closeness. She understood her children’s difficulty with taking care of her while they had to make a living. Meanwhile, Mrs. Xu was certain that whenever she was in need, her children would give a hand. She said,

Children are busy but they are filial to me. My son, grandson and daughters are all filial. I know if they come to visit me too often, they may lose their bonus. But if I am sick, they will all come.

Throughout the interview, Mrs. Xu complained about how one of the directors treated residents badly, as shown in the following:

The director Yang is financially well off but we are not. She looks down upon us, and she is mean to us…This is not only my opinion, we all say so…why she must take control and swear at us.

Mrs. Xu certainly did not like the way that the director Yang interacted with residents. However, she noted that the other director was a nice person. When she weighed the benefits and costs, rather than staying at home and hiring a private caregiver, Mrs. Xu showed strong preferences to stay in the facility.

As a configuration, this pathway showed weak support of social conditions, given that the outcome of home could be achieved with the absence of friendship, and only one route required family supports. In addition, the requirement for institutional conditions was also weak in this pathway since care was the only attribute from the institutional aspect. The estimated impact of

institutional and social supports seemed to be substituted by a strong presence of personal attributes, like hobby, freedom, and optimism. In other words, this pathway suggested that a strong presence of personal conditions could compensate for weak supports from institutional and social conditions.