Care for Whom: Diverse Institutional Orientations of Non-Governmental Elder Homes in Contemporary China

Background and Purpose: When the post-socialist Chinese state withdraws from providing the once famous cradle-to-grave security system to its citizens, non-governmental elder homes have mushroomed in China to meet the increasing needs of eldercare.  Despite their important contributions to the aging population, these service organizations are regarded as merely a subset of a homogeneous “emerging third sector” in China and their management strategies and organizational mechanisms often escape the attention of current research (Wong, 2008).  This study examines how non-governmental elder homes in L District of Taizhou, a city in south China, address different demands and expectations in the local market and cope with various antagonisms in the field of social service that have occurred during the post-socialist reforms in their diverse institutional orientations. 

Methods: Three-week ethnographic fieldwork was carried out in the 12 non-governmental elder homes in L District in 2011 and qualitative data of their institutional orientations and interactions with the local state and the market were gathered through three ways: participant observation; 22 in-depth interviews with service providers, service users, and local officials; and local archives of elder homes.  The data were synthesized to answer how the elder homes develop along different paths, and how these non-governmental institutions respond to the state and the growing market.

Results:  Four types of institutional orientations are discovered among the 12 elder homes and they interact with the local state and the market economy in different patterns.  High-end elder homes, serving only the wealthy and healthy elders, aim at making profits in the market.  They advertise excessively to enroll enough clients and train the staff to obey the customers completely.  The owners welcome a free and competitive market for social service, although slightly dissatisfied with the minimal subsidies from the government.  Low-end elder homes, serving the severely ill parents of migrant workers, claim to solve problems for rural families by relieving the children from the burdens of care giving.  These institutions feel like dump sites, but the owners believe their “philanthropic business” is a unique type in the market and should receive more policy support.  Village-based elder homes, serving exclusively the elders in the communities, aim to reward the elderly for their previous contributions and preserve village traditions.  These institutions stay immune to the market and demonstrate indifference to state intervention.  Service-oriented elder homes, serving a diverse pool of clients, pursue the goal of providing home-like care.  The owners treat the elders as their own parents and experiment with innovative service models.  They disapprove of the market ideology of profiting from eldercare and persistently demand the local state to offer adequate support to sustain their institutions.

Conclusions and Implications: Distinct institutional orientations, with different perceptions of the market economy and different expectations of the local state, have emerged in non-governmental elder homes in L District.  Public policies and curriculums of social service need to understand the diverse mechanisms of the organizations and their complex linkages with the state and the market to foster future development of the non-profit sector in China.