chinese older people policy... · is indebted to mr alex o’neil and dr emma stone of the...

PPP R E S S

The•POLICY

Chinese older peopleA need for social inclusion in two communities

Wai Kam Yu

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WWWWWai Kam ai Kam ai Kam ai Kam ai Kam YYYYYu u u u u is Senior Lecturer, Division of Social Studies, City University of Hong Kong.

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Contents

Acknowledgements ivExecutive summary v

1 Background and approaches to the study 1Background 1Research methods 2

2 General profile of Chinese people 3The characteristics of Chinese people in the UK 3Chinese people’s survival strategy in the UK 4Their problems 4Attachment to the Chinese community 5Attachment to mainstream society 7Difficulties of making attachment to two communities 8

3 Summary of the interview findings 9Characteristics of the respondents 9Care needs 9Detachment from the Chinese community 10Detachment from mainstream society 12Some contradictions between attachment to the Chinese community and to mainstream society 13Summary 13

4 Chinese women and middle-aged men 15Chinese women 15Middle-aged men 17

5 Social institutions for social networking 19Introduction 19McDonald’s restaurants in London’s China Town 19Casinos 20Churches 21Summary 21

6 Promoting double inclusion in two communities 23Five barriers pointed out by the Home Affairs Committee Report 23Problems overlooked in the Home Affairs Committee Report 24Suggestions from Chinese older people 25Suggestions from professionals 26

References 27Appendix A: The research method 29Appendix B: Interview findings 30

iv

Chinese older people

Acknowledgements

The author would like to thank all theorganisations and individuals who have providedprofessional advice, practical help and emotionalsupport throughout the process of the researchand the production of this report.

First of all, special thanks must go to the JosephRowntree Foundation. Without their generousfinancial support, both the research and thisreport would not have been possible. The authoris indebted to Mr Alex O’Neil and Dr Emma Stoneof the Foundation, who have contributedinsightful advice throughout the process.

Second, special thanks also go to other membersof the research team at the Department ofSociological Studies, University of Sheffield:Professor Alan Walker, who was the supervisor ofthe research project, has provided a great deal ofguidance and support in all aspects of the work,and Mrs Marg Walker, who providedadministrative support, has impressed the authorwith her superb IT and communication skills.

Third, the author is also indebted to othermembers of the Advisory Committee, for theirsupport and contribution to the discussion:

Revd Dr Michael Bayley, St Mary’s ChurchMrs Jie Bing Chan, Lai Yin AssociationMrs Yuk Fong Chan, Lai Yin AssociationMs Ruby Chau, Lai Yin AssociationMr Jim Kennedy, Social Services InspectorateMs Ruth Midgley, Community Care DevelopmentUnitMr David Phillips, University of SheffieldDr Lorna Warren, University of Sheffield

Furthermore, the author is grateful to a number ofindividuals and organisations who have providedadvice and/or practical assistance. They includeDr Duncan Scott and Professor Paul Wilding of theDepartment of Social Policy and Social Work atthe University of Manchester; the Soho Fellowshipof the Chinese Christian Church in London(special thanks go to Revd Chi Shing Wong, AhKong, Leila, Chun Kuan, Raymond and others);the Wing Hong Elderly Association in Glasgow(special thanks go to Mr K.Y. Lee, Mr Paul Chowand their colleagues); the Glasgow ChineseChristian Church (Revd C.K. Pun and Mr SimonShiu in particular); the Sheffield Chinese ChristianChurch (Mei Yu, Fong and Mr Chan in particular);the Doncaster Chinese Older People’s LuncheonClub (Nancy, Mr and Mrs Ng, Mr and Mrs Chek inparticular); and the Lai Yin Association inSheffield.

Last but not least, the author feels most thankfulto all the Chinese older people who have takenpart in this research. Many of them haveunreservedly shared their views and life stories.Their contribution to the research is unique. Theirparticipation makes the author firmly believe thatolder people are not passive agents waiting to beresearched and assisted. Instead, they play anactive role in defining their own needs,interpreting their circumstances and pursuing theirideal life. This research belongs to them. It wouldnot be meaningful if it could not help othermembers of the society to understand them moreor bring any positive changes to the life ofChinese older people.

v

Based on the belief that Chinese older people inthe UK should have the opportunity to voice theirviews and to be listened to, this study examinestheir caring needs from a user’s perspective. Inthe study, 100 Chinese older people in SouthYorkshire, London and Glasgow wereinterviewed, both individually or in focus groups.The main conclusions are described below.

Main conclusions

In common with senior citizens of other ethnicminority groups, Chinese older people arevulnerable to a number of disadvantages inadjusting to retirement. Many of them try toovercome disadvantages by attempting to attachto both the mainstream community and their owncommunity.

However, to achieve this attachment is not aneasy task. A number of them suffer detachmentfrom one of the communities; some sufferdetachment from both.

The common causes of their detachment from themainstream community include language barriers,insufficient knowledge of social and publicservices, lack of sense of social rights, lowexpectations of their lives in the UK, negativeexperience of retirement, poor mental andphysical health and low self-image.

Factors leading to detachment from their owncommunity include inadequate supports fromtheir family, low physical mobility and poor socialnetworks.

To strengthen their opportunity of attaching to

both communities, it is necessary to improve theirparticipation in community life and in the care-giving process, make their needs more visible:strengthen their access to social and publicservices, build higher expectations of their lives inthe UK, and increase their chances of learningnew skills and gaining knowledge.

Detachment from the mainstream community

Social and public services are important means forolder people to meet their needs and to achieve ahigher quality of life. However, the majority ofrespondents (97%) found it difficult to use theservices. The common difficulties included beingunable to speak English and to understand theterms and jargon of the public and social servicessystem, lack of information about social andpublic services and their sense of rights, andfinding the costs of using social and publicservices too high to meet. These difficulties areillustrated in the following quotes:

‘‘I don’t know even a single English word;how can I use the services. I will usewhat they give me.’’

‘‘Of course, the more services the better.But I hate filling in forms. I also hateasking people to fill in forms for me. Ifyou ask people for help, you will becometheir burden and sooner or later annoythem.’’

‘‘I am afraid of being sent to an olderpeople’s home because I don’t knowEnglish. I would be seen as an idiot andsoon become a real idiot.’’

Executive summary

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‘‘I don’t want to tolerate their (workers’)unfriendly attitude. It doesn’t matterwhether I use more or less services.Dignity is the most important thing tome.’’

Many respondents were not satisfied with theirlives in the UK. Ten refused to discuss their viewand 35 shared explicitly negative views,including the following:• Life in the UK is boring and the daytime is too

long.• Living in the UK means speaking a second-

class language and being given only second-class citizen status.

• Some respondents mentioned that they werenow waiting for three things: ‘waiting to eat,waiting to sleep and waiting to die’.

• Some described themselves as ‘half deaf andhalf blind’ because of language barriers.

The self-image of respondents in general was low.Over half of them (65) thought that they wereseen as ‘useless’ and ‘burdens’, because they nolonger made any contribution to society and theirfamily. Only a few (7) thought of themselves ascitizens and enjoyed the same rights as membersof the mainstream community. Moreover, overhalf of the respondents (55) described their moodas a little sad or very sad most of the time. Overone third thought that their future was full ofuncertainty, which is certainly detrimental to theirmental health.

Sixteen interviewees compared the services theywere using with those provided for older peoplein Hong Kong. Ten complained that the servicesthey received were less than those provided inLondon and Manchester. However, nointerviewees compared themselves with olderpeople of other ethnic groups. This underminedtheir determination to fight for services and rightsthey deserved as British citizens.

Detachment from the Chinese community

Many Chinese families run Chinese take-aways toearn their livings. The need to avoid competitionmakes them keep each other at a distance. Thisreduces their chances of interaction and contact.Undeniably, most Chinese people identifythemselves as the same group culturally, and theyoccasionally come together to celebrate Chinesefestivals. However, this kind of interaction and

contact is exceptional rather than being a part oftheir normal daily life. Few Chinese deal withtheir problems on a community basis or activelypromote their interests as a community. Most oftheir concern is limited to their family. Littleattention is paid to anything beyond thisboundary.

A number of older people attach their emotionsand memory to the China Towns and go thereregularly to spend their leisure time. However,because of lack of sufficient facilities for olderpeople in the China Towns, many have no choicebut to stay for the whole day in McDonald’srestaurants or in casinos.

Additional studies of Chinese women and middle-aged men show that their ability to provide carefor dependants is often exaggerated. In commonwith older people, they face a number ofdifficulties in using formal caring services such aslanguage barriers, lack of sufficient knowledge ofsocial services, and difficulties in expressinghealth concepts from their own culturallyperspective. Moreover they have their ownproblems to deal with such as generation gaps,economic pressure and occupational illness andrelated problems. However, there are inadequateservices to meet these needs – especially formiddle-aged men – and few studies of theirproblems have been done.

With some shift in emphasis from assimilation tocultural pluralism, more attention is given to thecultural way of life of ethnic minorities. However,too much stress on the cultural factor may easilylead to the over-emphasis of the caring capacity ofthe Chinese community, and the neglect of thedivisions between Chinese people, such asdivisions between professionals and layman, andbetween places of origin, social class and gender.For example, Au and Siew (1997) criticise someprofessionals for using the ‘dumping approach’ indealing with Chinese people with mentaldisability. On the grounds that ‘this is yourproblem, over to you’, they tend to refer the casesto the Chinese community, although the latter isnot necessarily well equipped to understand andto take care of people with mental illness.

vii

Suggestions for improving theattachment of Chinese older people

The suggestions for integrating Chinese olderpeople into both the Chinese community andmainstream society stress participation, visibilityof needs, access to services, higher expectationsand lifelong learning opportunities.

Participation• to organise a national forum to promote the

rights of Chinese older people and to voicetheir demands for caring services;

• to set up fact-finding and inspection teams ofChinese people to assess formal caringservices for Chinese older people;

• to discuss with professionals how to improvecommunication and develop an effective andequal relationship in the care-giving and care-receiving process;

• to develop a training menu from a user’sperspective for training professionals to meettheir needs;

• to provide more opportunities for Chineseolder people to take an active role in theinterpretation process; for example, to helpthem understand the role played byinterpreters and their limitations in theinterpretation process;

• to teach them to use the complaint systems forformal caring services;

• to encourage them to take part in voluntarywork (for example, to ask them to teachcooking skills, Chinese culture and Chineselanguages in community centres).

Visibility of needs• to give them the right to choose their own

diets in residential homes;• to provide more ‘walking wardens’ to visit

them regularly;• to help them solve their family problems, such

as generation gaps and the difficulties involvedin communicating with their grandchildren,and to make their families aware of their needsand problems;

• to make the public aware of the importance ofpromoting mental health and the Chinese wayof defining and expressing mental illness andmental health;

• to invite active users of caring services to actas exemplars, in order to encourage moreChinese older people to use caring services tomeet their needs;

• to encourage interpreters to develop commonterms for interpreting the health concepts ofChinese older people.

Access to services• to provide more social and community services

in China Towns, where many of them spendtheir leisure time almost every day;

• to subsidise them to purchase Chinese herbsand to consult Chinese medicinepractitioners;

• to provide more residential homes;• to run courses to teach them to fill in

application forms for social services;• to open social centres in unsocial hours;• to sponsor their family members to receive

interpretation training;• to employ more bilingual workers in the

formal caring services;• to provide Chinese television programmes to

promote caring services;• to provide hot-line services for them to enquire

about social services and to discuss theirrights;

• to provide more opportunities for all Chineseolder people to join luncheon clubs;

• to set up information counters for promotingformal caring services in the Chinese people’smeeting points, such as McDonald’srestaurants in London’s China Town, casinosand churches;

• to establish ‘sales’ teams to take a pro-activeapproach to contacting Chinese older peopleindividually to introduce formal caringservices;

• to teach Chinese older people to useemergency services, such as alarm bells athome, before they face a crisis;

• to run more case conferences to share theexperiences and skills for meeting the needs ofChinese older people with mental illness;

• to provide more outreach workers to identifyand meet the needs of home-bound olderpeople.

Higher expectations• to subsidise Chinese older people to travel to

different cities and visit different Chinesecommunities;

• to help them to have a more positiveevaluation of their working life and higherexpectation of their retirement life;

• to provide opportunities for them to contactolder people of other ethnic groups, in order

Executive summary

viii


to enable them to understand their commonneeds and rights.

Lifelong learning opportunities• to provide them with opportunities for learning

English and other languages;• to provide more skill training programmes in

order to help them find jobs;• to provide training courses for both Chinese

older people and middle-aged groups toprepare for their retirement lives, and tounderstand the welfare rights of retirees;

• to invite Chinese older people to teachprofessionals about Chinese culture and theirways of defining and meeting needs.

About the study

This study is based on interviews in 1998 and1999 with 100 Chinese older people in London,Glasgow, Rotherham, Doncaster, Sheffield andBarnsley. To supplement these interviews,several other studies have also been done,including a survey of the health of Chinesewomen, a review of the Home Affairs CommitteeReport on Chinese people, a study of the needsand problems of middle-aged Chinese people, astudy of Chinese ex-mentally ill patients, a studyof the attractiveness of meeting points for Chinesepeople, and a study of the views of professionalson the improvement of the social and economicposition of Chinese older people.

1

Background

The 1991 Census indicated that the total Chinesepopulation was 156,938, constituting the sixthlargest ethnic minority in the UK (Cheng, 1996),of whom 3% of males and 6% of females were ofpensionable age (Owen, 1994). In common withsenior citizens of other ethnic minority groups,Chinese older people are vulnerable to a numberof disadvantages arising from racism, deteriorationof their physical health, and difficulties inadjusting to retirement. As will be shown inChapters 2 and 3, many of them try to overcomethese disadvantages by attempting to attach toboth the mainstream community and their owncommunity. Their attempt to make attachments totwo communities is not only a way to achieve alife with security and dignity, but is also related tohow their identity is constructed andreconstructed. However, it is not an easy task toachieve these attachments; it is a life-long battle –in which not all are successful.

Although age differences are important wheninvestigating the attachment of Chinese olderpeople to their own community and themainstream community, it is also important tonote that many problems suffered by Chineseolder people are related to problems faced byother age groups within the Chinese communityin the UK. Chinese people are often seen as aninvisible community in the social and politicalspheres (Yu, 1991). They seldom seek help fromcentral or local government to meet theirdifficulties in maintaining their attachments toboth the mainstream and the Chinesecommunities (Jones, 1998). Social servicesallocated to them are far fewer than their numbersand needs would appear to justify (Chau and Yu,forthcoming). Few try to take actions to make

their needs known. Their low profile in societyraises four questions:

1. Is the Chinese community able to solve itsown problems without relying on mainstreamsocial services?

2. Does the Chinese community still maintain itstradition of looking after older people andother dependants?

3. Do Chinese people prefer to play a low profilein the UK?

4. Do Chinese people have their own networksthat enable them to maintain their quality oflife and are they able to maintain a high levelof cohesion in their community?

This study is intended to investigate the careneeds of Chinese older people from their ownperspective. It is not mainly concerned withanswering the above questions. However, theanswers to these questions will definitely enhanceour understanding of the needs and problems ofChinese older people. If the Chinese communityis both able and willing to meet the needs of theirdependants – including older people, to solvetheir own problems and to maintain a highcohesiveness among themselves through theirown networks, it may not need help from publicand social services. However, if the Chinesecommunity fails to meet these needs, it is worthconsidering the necessity for providing morepublic and social services to meet the needs ofChinese older people and the Chinesecommunity. Hence, to understand the needs andproblems of Chinese older people, it is necessaryto make a study of the needs and problems of theChinese community. Based on this assumption,several research methods are used in collectingand analysing information.

Background and approaches tothe study

1

2


Research methods

Semi-structured interviews

One hundred Chinese older people from London,Glasgow, Rotherham, Doncaster, Sheffield andBarnsley were invited to attend the interviews.These interviews, however, are more thanexercises in collecting information. They aim toencourage interviewees to play an active role indefining their needs, assessing caring services andformulating proposals for meeting theirdifficulties. In order to achieve this, stress is puton maximising their participation in the researchprocess. Interviewers started the research processby entering the social circles of Chinese olderpeople and contacting potential interviewees. Thisnot only enabled them to understand more aboutthe Chinese community, but also providedsufficient time for interviewees to understand theaims and contents of the research project beforethey considered whether or not to agree to beinterviewed. Moreover, the research method ofsemi-structured interviews was used to giveinterviewees more opportunities in sharing theirviews and in exploring the possibilities forimproving their quality of life.

Observation

During the process of contacting interviewees, theinterviewers had a chance to observe howChinese older people organise their social circles,and look at why and how some public places,such as McDonald’s restaurants in London’s ChinaTown, casinos and Chinese churches provide afavourable arena for them to organise their socialnetwork. This discovery provides insight into thecharacteristics of the Chinese community and theways in which Chinese older people develop theirsocial network, seek information andcommunicate their views to each other. Moreover,examination of the places where Chinese peopleorganise their activities will give an insight intothe development of methods for disseminatinginformation about social services and improvingthe attractiveness of social and community centresfor Chinese older people.

Focus groups

Eighteen older people in London were invited tojoin three focus groups to discuss the preliminaryfindings of the semi-structured interviews andmake suggestions on the improvement of theirpolitical, social and economic positions.

Supplementary studies

Three supplementary studies were undertaken toexplore the needs and problems of the Chinesecommunity. Chinese women and middle-agedmen are often seen as the main care providers inthe Chinese family. Two studies were conductedof their social and health needs, and their caringability. Moreover, a number of professionals,including community workers, workers inluncheon clubs, home-help workers, social workstudents, committee members of Chineseorganisations and deacons in the Chinesechurches, were invited to make suggestions onthe improvement of the older people’s political,social and economic positions. In addition, eightChinese people with mental-health problems wereinterviewed in Glasgow and London. Six of themwere older people. The focus of these interviewsis on their needs for reintegration into both themainstream community and their own community.

Organisation of the report

Chapter 2 discusses the characteristics andproblems of the Chinese community based onliterature and document reviews. Chapter 3presents the findings of the interviews withChinese older people. Chapter 4 discusses thefindings of the study on Chinese women andmiddle-aged men. Chapter 5 examines the socialinstitutions in which Chinese older people buildtheir social networks. Chapter 6 offers suggestionsfor improvements for Chinese older people basedon the discussion from the focus groups and theinterviews with the professionals. Appendices Aand B discuss the technical details of the researchmethods.

3

This chapter discusses the characteristics andproblems of the Chinese community, theproblems that the Chinese community encountersand possible ways to solve these problems. Thediscussion is based on information drawn fromthe literature and document reviews.

The characteristics of Chinese peoplein the UK

Population

Chinese people in the UK are a heterogeneouscommunity made up of members from diverseorigins and speaking different dialects, such asCantonese, Hakka, Mandarin, Vietnamese, Wai-touand Hokkin. The group which came from HongKong constitutes one third of the population,about a quarter were born in the UK, the restcoming from Singapore, Malaysia, Taiwan,Vietnam and mainland China (Chan and Chan,1997). Most older people are former Hong Kongresidents with Cantonese and Hakka as their maindialects. Only a few can speak English.

In response to the reintegration of Hong Kongwithin Mainland China, 50,000 families were givenBritish citizenship. However, there are noavailable data showing how many of them havesettled in the UK. The proportion of people fromHong Kong in the Chinese community hasprobably increased since 1997.

Immigration history

The majority of Chinese immigrants arrived in theUK in two waves. The first took place in the late1950s. Most were young males coming from rural

areas of Hong Kong. Although they had marriedvillage girls in Hong Kong, most still left theirwives behind and worked alone in the UK(Federation of Chinese Association in Britain,1985). This was because their wages were notsufficient to support their whole familycomfortably. In the late 1960s more and moretried to bring their relatives to the UK. This wasmainly a response to the Amendment to theCommonwealth Immigration Act, which requiredboth parents of a child to be resident in the UK asa precondition for giving the child the right ofabode (Taylor, 1987). Thereafter, more Chinesepeople of different age groups came to the UK.

Many Chinese people left their places of origin inorder to earn a living. This is evident in the closeassociation between the immigration wave andthe deteriorating economic conditions in ruralHong Kong, and in the rise in demand for ethniccuisine in postwar UK. However, the economicfactor is not the only reason for the arrival ofChinese people; the political factor also plays animportant part.

Hong Kong was a UK colony from 1841 to 1997.It was acquired by the UK not as a settlement forthe British, but mainly for setting up a diplomatic,commercial and military post in order to securetrade with China (Kuan, 1979). The Hong Konggovernment was much more concerned withestablishing a profitable investment environmentfor the private sector, especially British firms, thanwith fulfilling any political and cultural ideals (Yu,1996). To develop the manufacturing sector andsecure prosperous trading, it concentrated onbuilding the infrastructure and public facilities inurban areas; little attention was paid to the needsof residents in rural areas. Instead of arresting thedecline of the agricultural sector and solving the

General profile of Chinesepeople

2

4


economic difficulties of farmers, it took an activerole in buying agricultural products from mainlandChina, in order to lower the cost of production inHong Kong (Schiffer, 1991). Facing keencompetition from mainland China, and theapathetic attitude of the Hong Kong governmentto their livelihood, many people in rural areas feltthat taking the risk of coming to the UK was theonly way to solve their economic difficulties.

Chinese people’s survivalstrategy in the UK

Chinese people are active participants in theeconomy: 70% of Chinese men and 50% ofChinese women are defined as economicallyactive in the 1991 Census. Of these, 88% of menand 90% of women are in paid jobs (Cheng,1996). Certainly this is partly due to the expansionof the catering industry in the 1960s and 1970s.However, the main reason lies in the Chinesepeople’s attitude to work and their adaptability inthe job market. The history of Chinese immigrantsin the UK is a history of striking out for survival inthe private market. The first Chinese settlers in theUK ran small shops for visiting Chinese seamen inthe late 19th century. As fewer Chinese seamencame to the UK, people shifted to laundryservices – in 1931 there were over 500 Chineselaundries in the UK (Federation of ChineseAssociation in Britain, 1985). In response to thedecline in demand for laundry services, theystarted to work in the Chinese restaurant businessand run Chinese take-aways, which had a fastgrowth in the 1960s. They use the traditional waysof securing standardised, efficient and low-costproducts by working long and unsocial hours,recruiting labour from their family members,stressing family and emotional ties betweenemployer and employees, and accepting a lowmonetary return for their efforts.

It is important to note that working in Chineserestaurants and family-based take-away shops is away for Chinese people to maintain attachment totheir own community. This is not to say that theworking conditions of these jobs are better thanelsewhere; conflicts between employers andemployees are not uncommon in the Chinesecommunity. However, as they share the samelanguage and culture, it is easier for them tounderstand the rationale behind the rules andworking habits. Moreover, the employees can takea more active role in making sense of their

workplace, even though they might not agreewith the rules. The Chinese Action Group (1985)discovered that some managers of Chineserestaurants regard running the business as similarto running a traditional extended family system.They treat their subordinates as family membersand meet their needs beyond those related towork. Compared to restaurants, the family-basedtake-away business has even greater strength inenhancing Chinese family values. Chinese take-aways provide a chance for family members totake care of each other and, through workingtogether, to develop a sense of commitment tofamily (Song, 1995).

The above discussion shows that many Chinesepeople do not intend to confine their life withintheir own community; nor do they have a strongdesire to attach to the mainstream community.Rather, they maintain a double-attachment to thehost society and their own community: theirattachment to the former is mainly achieved byparticipating in the private market and therelationship is basically commercial; theirattachment to the Chinese community is mainlyachieved through the family or working in theChinese restaurants.

Their problems

Many Chinese found their life in the UK difficult.Their difficulties include the following:

Economic uncertainty

The high participation rate of Chinese people inthe labour market and low unemployment do notnecessarily reflect that all Chinese people enjoy adecent standard of living. It is quite well knownthat Chinese people in the catering industrieswork long and unsocial hours (Home AffairsCommittee, 1985). This not only reflects theirwillingness to work hard, but also shows that theyare under huge economic pressure. RunningChinese take-aways is to a certain extent a riskybusiness. Herald Europe (1998) estimates that 20%of owners need to close down or sell theirbusiness to other people. The failure in running acatering business not only means loss oflivelihood but may also imply personal failure. Itis not uncommon for those who lose theirbusinesses to move to other cities in search of asuitable investment environment to re-start theirtake-away businesses.

5

Occupational hazards

As a result of a heavy workload and highvulnerability to occupational hazards, manymiddle-aged and older workers suffer from healthproblems and find it difficult to continue to work.According to Owen (1994), the health of olderChinese people deteriorates much faster thanwhite people of the same age. As will be shownin Chapter 4, many middle-aged Chinese peopleare worried that unexpected occupational hazardsand illness will deprive them of their ability towork. In fact, these incidents are common in theChinese community. Despite this and theirworries, few have made concrete retirementplans. The interview findings also reveal thatsome older people do not realise the importanceof joining pension schemes before their retirementbecause they do not understand their social rightsand the social welfare opportunities available tothem.

Hidden unemployment

Hidden unemployment is not uncommon amongChinese people. To avoid the status of beingunemployed, some previous surveys show that itis not unusual for Chinese families to invite theirmembers to work in their Chinese take-awayseven though they are not economically necessary(Chan, 1986). This is an important reason whyChinese people have a low take-up rate formeans-tested benefits.

Limited use of welfare services

As mentioned in Chapter 1, many Chinese peoplefind it difficult to use social and public services tosolve their problems due to a number of reasons:language barriers; lack of understanding of theirrights; absence of experience of contactingprofessionals; and low expectations of socialservices (Shang, 1985; Chiu, 1991; Jones, 1998).

In view of the attempts of many Chinese peopleto organise their lives with attachments to boththe mainstream society and their own community,there are two possible approaches to the aboveproblems. The first is to seek help from their owncommunity; the second is to rely on the publicand social services provided by the mainstreamsociety. However, whether these two approachesare effective, or not, are debatable. They dependon several conditions.

Attachment to the Chinese community

The effectiveness of this approach is based ontwo conditions. The first is that the cultural factorstill plays an important role in shaping Chinesepeople’s lives in the UK. As a result, they stillfollow the traditional practices of helping themembers of their own community and family. Thesecond is that the Chinese community is cohesiveand capable of providing care for theirdependants.

Cultural factors

Some analysts believe that the above twoconditions exist in the Chinese community in theUK. Their views are represented by the followingquotes:

The Chinese community is still fairlyconservative in nature sticking well withinits own created socio-economic sub-culture. It is mainly family oriented andhence many of the traditional Chinesevalues still hold. The insistence, forexample, of hard work, self-reliance, lowprofile virtual non-competition in thecurrent job market, lack of lobbying onbehalf of the community at localgovernment or national level, not askinganything from the host community has ledto this introversion. (Wong, 1985, p 14)

The Chinese in Britain were neverconcerned to develop social relationshipsoutside their own closed communities andit is much the same today. Until recentlythey have regarded themselves assojourners rather than settlers, resolutelymaintaining their Chinese culture andcontinuing to identify their kinsmen athome rather than with the hostcommunity. (Jones, 1979, p 398)

Moreover, some professionals and academics usea cultural perspective to explore the needs ofChinese people and suggest approaches tohelping them. For example, Lau (1997) tries toprove the importance of education in the eyes ofChinese people by presenting historical evidence– such as the fact that the Han Emperor Wudi in124 BC established an appointment system ofofficials based on education and individual ability;the practice of competitive recruitment, which asdeveloped in the Tang Dynasty in the seventh and

General profile of Chinese people

6


eighth centuries; and public examinations, whichwere developed into three sophisticated levels inthe Sung Dynasty (AD 960–1279).

Given the long recorded history of China and thefact that many Chinese people came to the UKthrough kinship, it is impossible to ignore thecultural factor in studying the needs of theChinese community. Chinese people havedeveloped sophisticated ways of defining health,using herbal medicine, conducting familyrelationships and sustaining moral order. It isdifficult to meet their needs effectively if thesecultural traditions are neglected.

However, it is important to avoid the over-emphasis of the importance of traditional valuesin the Chinese community, and subsequently theassumption that Chinese people are unwilling tointegrate themselves into mainstream society.Chiu (1989, 1991) presents both historical andempirical evidence to argue that the influence oftraditional values in Chinese society is often over-estimated. His study of Chinese families inLondon shows that many older people did notreceive sufficient care from their families due tothe unsocial working hours of family members,the generation gap and deteriorating familyrelationships. His review of history discoveredthat the ‘traditional family values’ were notgenerally held even in traditional Chinese society.The ideal family model with all married sonsideally living under the same roof with theirparents was found mainly in rich people’sfamilies. For the ordinary family whose livelihooddepended almost solely on land rented from therich, large family size was of much less practicalvalue (Chiu, 1991). Many had to control theirfamily size because of food shortages. It is notunusual to see that the poor delayed theirmarriage while waiting for the older generation todie or for their economic fortunes to improve.

Moreover, too much stress on cultural factors mayeasily lead to the conclusion that ‘the Chinesemust know the needs of Chinese’. This viewoverlooks the divisions among Chinese people,such as divisions between professionals andlaymen, between places of origin, social class andgender. Au and Siew (1997) criticise someprofessionals for using the ‘dumping approach’ todeal with Chinese people with mental-healthproblems. On the grounds that ‘this is yourproblem, over to you’, they tend to refer the casesto the Chinese community although it is notnecessarily well-equipped to understand and take

care of people with mental illness (Au and Siew,1997, p 15).

The Chinese community

It is important to note that the degree of cohesionof the Chinese community is much less than iscommonly assumed. Many Chinese people stillidentify themselves as members of the samecommunity in that they share the same heritage,culture and languages, but the ability of theseelements to bind them together is undermined bypotential conflict of interest. To understand this, itis necessary to note two points. First, the Chinesecommunity is shaped, not only by cultural factors,but also by the ways in which the Chinese seekeconomic survival. Second, their ways of seekingeconomic survival, especially in the cateringindustries, undermine their chances of building acohesive community. This is illustrated below.

The Chinese catering trade can roughly be dividedinto two types: Chinese restaurants and Chinesetake-aways. As a result of free entry into themarket and high price elasticity of demand forChinese foods, the owners face keen competition.To secure survival they usually adopt two kinds ofstrategies. The first is to stick together in a smalldistrict, such as the Chinese restaurants in the‘China Towns’ of London and Manchester. Sincethe restaurants often sell similar food, they cannotavoid intense competition. The restaurant ownersare careful in deciding their prices, because anybad decisions will inevitably result in losingcustomers to their rivals. Moreover, they have tocontinuously change what they sell in order toattract customers’ attention. In the 1950s mostrestaurants only sold ‘chop suey’ (Watson, 1977).Restaurant owners had to improve their foodbecause of the competition, and as a result, moreauthentic Cantonese- and Beijing-style foods havebeen available since the 1970s. Moreover, peoplealso run theme restaurants in China Towns. Thesekinds of restaurants derive their reputation fromexpertise in a particular type of Chinese food.

In return, a high concentration of restaurants in asmall district brings attractive economic benefits.The district can build its reputation as a meetingpoint for the Chinese and a site of interest fortourists. This is exemplified by the China Town inLondon in which there are not only top-classChinese restaurants for international tourists butalso a number of travel agencies, barber’s shops,grocery stores, book shops, and solicitors’ offices

7

which provide services for the local Chinese(Watson, 1977). Since China Towns have becomewell-known places, their restaurants areguaranteed a steady number of international andlocal customers.

The second strategy is to resort to a geographicdifferentiation (Lipsey, 1993). This is commonlyused by Chinese take-aways, which employ themajority of the Chinese engaged in catering. Themain aim of the strategy is to avoid competition.To achieve this, the Chinese take-aways try tokeep a reasonable distance away from each other.This is important to the survival of the Chinesetake-aways. Since most are run only on a limitedamount of capital and are not able to hire first-class chefs (Shang, 1984), they cannot afford tomake large-scale innovations nor to differentiatetheir menus from their rivals to any great extent.As a result, the meals sold by Chinese take-awaysare virtually the same, which is why Chinese take-aways have become dispersed widely acrossBritain.

It is also important to note that the Chinese take-away is usually family-based – almost everyChinese take-away is run exclusively by a singlefamily and the family members provide the mainsupply of labour (Baxter, 1988; Song, 1995). Thescattered distribution of take-aways also meansthe scattered distribution of the Chinese families.As observed by Owen (1994), there is relativelylittle regional variation in the Chinese residentpopulation. This explains why the Chinesecommunity is not a strong territorial group andChinese people lack a common territorialaffiliation (with the exception of the ChinaTowns).

Physical distance implies social distance, but theChinese are not only geographically divided, theyare also socially divided (Taylor, 1987). While theowners of Chinese take-aways are in a sensemembers of the same community, they are at thesame time potential competitors for the samegroup of customers. This attitude affects theirapproach to getting on with each other (HeraldEurope, 1998). Researchers in Chinese studieshave cited evidence that the Chinese attempt tohide personal and business information from eachother (Taylor, 1987; Yu, 1991). Cheung (1975) alsonoted that Chinese proprietors avoided visitingtheir potential rivals’ working places. In fact,attempts to prevent potential rivals from gatheringclear market information are commonly used as away to erect market barriers against newcomers.

Given that cultural factors are not as important asit is assumed in shaping Chinese people’s lives,and the cohesiveness of the Chinese community isundermined by Chinese people’s need to seekeconomic survival, it is doubtful whether theChinese community can provide sufficient supportto solve its own problems.

Attachment to mainstream society

Whether Chinese people can solve their problemsthrough the use of public and social servicesdepends on whether there are sufficient culturallysensitive services to meet their needs, andwhether Chinese people understand their rightsand are able to cope with some barriers (such aslanguage barriers and the lack of understanding ofthe existing social and public services) in usingthe services. The results of previous studies throwdoubts on the existence of these conditions(Shang, 1985; Chiu, 1991; Jones, 1998).

Moreover, it is doubtful whether Chinese peoplehave sufficient basis to form a strong local interestgroup to protect their interests as users of publicand social services. As mentioned above, theChinese community is mainly made up of a sumof geographically dispersed families. This affectstheir chance of receiving social services (Eaton,1999). Nationally, the Chinese form a substantialgroup, but their numbers are few in many singlelocal authority areas (Home Affairs Committee,1985). Since most social services are provided andadministered according to the boundary of thelocal authority and the social composition withinthe boundary, it is not surprising to find that theneeds of the Chinese are not taken seriously intoaccount by service providers (Chan and Chan,1997). There is no district where the Chinese arethe largest ethnic minority group. Localauthorities are concerned with the needs of ethnicminorities, but they are less likely to provideservices tailor-made for the Chinese. Moreover,Berthoud (1998) shows that there was a wide gapbetween high and low incomes in the Chinesecommunity: 28% of Chinese households are poorcompared to 16% of the white households. Thisfurther undermines the possibility of theircooperating to fight for their interests.

General profile of Chinese people

8


Difficulties of making attachment totwo communities

The problems suffered by Chinese peoplementioned above and the difficulties theyexperience in relying on either their owncommunity or the mainstream community haveexisted for quite a long time. As early as 1985, theHome Affairs Committee Report highlighted fivebarriers blocking Chinese people fromparticipating fully in British life – lack of English;ignorance of rights; cultural differences; scatteredsettlement; and long unsocial hours. Asmentioned in Chapter 1, this study is intended toexamine the care needs of Chinese older peoplefrom their perspective. It is not concernedwhether these five barriers have been removedover the past 15 years and whether the HomeAffairs Committee Report had missed otherbarriers. However, the care needs of Chineseolder people are not an isolated issue. Theirexperiences of using public and social services,and seeking help from their own community alsoreflect whether their tactics for meeting needs areeffective or not. The details of their experiencesbased on the semi-structural interviews are shownin Chapter 3.

9

As mentioned in Chapter 1, 100 Chinese olderpeople were interviewed in London, Glasgow,Doncaster, Rotherham, Sheffield and Barnsley.Details of the issues explored by the interviewsare given in Appendices A and B. This chapterconcentrates on discussing their problems ofdetachment from their own community anddetachment from the mainstream society.

Characteristics of the respondents

Thirty-nine respondents were male and 61 werefemale. The average age of interviewees was 71,the oldest was 84 and the youngest was 65. Theoriginal home of the majority (72) was HongKong, 27 came from mainland China, of whomeight had stayed in Hong Kong for more than fiveyears before arriving in the UK, and one was bornin Singapore. Fourteen interviewees arrived in the1950s, 35 in the 1960s, 39 in the 1970s and tenafter 1980. Two interviewees had returned toHong Kong but had come back recently.

Sixty-eight interviewees had worked in the UK, ofwhom 50 had worked full-time and 18 had beeneither part-time or temporary workers. Nine saidthat they never worked formally but had helpedout in their family’s take-aways from time to time,receiving no wage. The other 20 disclosed thattheir main purpose in coming to the UK was totake care of either their children or grandchildrenor both.

Of the interviewees who had worked before, 60had worked either in Chinese take-aways orrestaurants, four worked in Chinese shops andfour did not disclose the details of their careerhistory. None of them had worked in the cateringindustries before coming to the UK. Many who

came from Hong Kong used to be farmers livingin rural areas – the New Territories (35). The resthad been in other occupations, such as factoryworkers, bus drivers and construction workers.

Care needs

Almost 40 respondents said their health was good(21) or very good (18). The majority could takepart in most of the activities of daily living, suchas bathing, washing and dressing without the helpof other people. However, many of them haddifficulties in using transport services, such aspublic transport (52) and taxis (78). As a result,they seldom travelled to other cities alone.Making household repairs was another difficultyfaced by the interviewees – 42 found it difficult tocarry these out by themselves.

Only 14 interviewees complained that they hadtoo little money to support a decent standard ofliving, and about two thirds (68) of theinterviewees said that the money they receivedwas sufficient.

Although the majority were able to look afterthemselves in their daily lives and did not havefinancial problems, many of them did not findtheir life a happy one. Fifty-five respondentsdescribed their mood as a little sad or very sadmost of the time, over a third (38) thought thattheir future was full of uncertainty, and 35respondents did not like their current life in theUK. Of those, 25 found it boring and felt thedaytime was too long. It was hard for them to findsomething meaningful to do every day. Quite anumber of them (30) thought that they were‘second class’ citizens because they could notspeak English, and as a result made them nodifferent from ‘half deaf and half blind’. There was

Summary of the interviewfindings

3

10


also a common saying among the respondentsthat Chinese older people were now waiting forthree things: waiting to eat, waiting to sleep andwaiting to die. It is important to note that tenrespondents refused to comment whether theircurrent life was good or not. A common reasonwas that they had no power to make any changes.Hence it was better to accept life as it was.

The self-image of interviewees in general waslow. Over half of them (65) thought that theywere seen as ‘useless’ and ‘burdens’ because theyno longer made any contribution to society and totheir family.

The above findings suggest that manyinterviewees needed more psychological supportand concern. However, they disclosed that it isdifficult for them to meet these needs by relyingeither on the mainstream community or their owncommunity. In fact, it is not uncommon forinterviewees to suffer a certain degree ofdetachment from these two communities.

Detachment from the Chinesecommunity

As mentioned in Chapter 2, the cohesiveness ofthe Chinese community is over-estimated. As aresult of long working hours and the necessity toavoid competition in the catering industries, manyChinese families keep each other at a distance. Asa result, older Chinese people can attach their lifeto the Chinese community only by attachment totheir family. The family is not only an importantcare provider, but also serves as the mostimportant place for the older people to find theirrole and purpose in life. However, over half of therespondents (65) did not have high expectationsof their family members in taking care of them forfour reasons: poor relationship with the familymembers, depreciation of Chinese traditionalvalues, pressure faced by their children and lowself-image.

Many lived alone (39), of whom 15 had nevermarried, 11 were either widows or widowers withno children and 13 were separated from theirspouses and children due to a number of reasons– marriage problems, health problems and

financial problems. A further 22 lived with theirspouses but not with their children. Nine havenot seen their children over the past two years, ofwhom six did not know either the address or thephone number or both of their children. Sevensaw their children occasionally, mainly onfestivals, their birthdays and when they hadproblems. The rest (39) lived with or very near totheir children. However, living together was not aguarantee of good relations. The common factorsundermining their relationship with childrenincluded the following: the children worked longhours and had no time to talk to them (16); theydid not know whether they were hosts or guestsin the families (12); and this put them in anembarrassing situation in the family decision-making process and in the events which requiredsharing financial resources (16); they wereworried that they would become burdens on theirfamilies (8); and they did not understand Englishand could not communicate with theirgrandchildren (7).

The interviewees (22) were not quite surewhether traditional Chinese values could still beapplied in the Chinese community in the UK, asthe younger generations were influenced more bythe western culture. Some (12) often usedincidents of abuse of older people in Hong Kongto justify that their situations were not the worst.

Twenty-nine interviewees thought that theirchildren faced a lot of pressure in their daily lives,such as competition in the catering industry, theneed to look after their own children anddifficulty in using mainstream services. Thus,they did not think that their children had sufficienttime and resources to meet their needs.

Many interviewees (25) suffered from low self-image when they were no longer able to help outin the take-away business or look after theirgrandchildren. Therefore, they did not think thatthey deserved care from their family.

Case studies

The following case studies will help illustrate theabove points.

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Case study 1Mrs A, aged 70, had lived in London for 28 years. Her husband came to the UK two years before her. She had runa Chinese take-away business with her family. After her husband died 10 years ago, she sold the business toanother Chinese family. She had three sons, all of whom worked in the catering business in other cities. Sheseldom visited them because she had very poor relationships with her daughters-in-law. She had never expectedthat she would need to live alone and received no support from her sons. She pointed out: “I am used to beingrejected by the mainstream society; but the experience of receiving rejection from my family is not only new butmuch more painful”. From time to time she wanted to visit her sons and see her grandchildren, but she thoughtit an insult for her as a senior family member to take the initiative to approach the junior members. She was alsoafraid that she would not be welcome there.

Case study 2Mrs B, aged 66, had lived in the UK for 41 years. She was married with four children. In her first 10 years in the UK,she worked in a restaurant kitchen washing dishes. As she had no chance of meeting British customers or time tolearn, she knew only simple English. She stopped working at the age of 35 to look after her children, and thereaftershe had even less opportunity of seeing people and learning the social and economic systems in the UK. Herhusband died 10 years ago, but her relationship with her children was not very good. At first she lived with hereldest son but, after her relationship with her daughter-in law turned sour, she arranged to live alone in a councilflat. Her other children (one son and two daughters), who live in other cities, seldom visited her. Only her eldestson visited her from time to time and gave her some pocket money. Her main income was from social benefits.However, she felt that she had sufficient money as she had nowhere to spend money except buying the basicnecessities.

Mrs B did not feel happy about her life in the UK. She always wanted to go back to her homeland (Hong Kong).However, she was afraid that she would not receive financial support from the government once she left the UK.Moreover, she did not think that she had sufficient money to rent a flat in Hong Kong. Furthermore, she wasworried that her relatives in Hong Kong might regard her as a burden if she stayed there permanently.

She felt life now was boring and empty. The daytime was simply too long and she passed most of her time bysleeping and watching Chinese videos. However, because she lacked money to buy new video programmes, shemainly watched the old ones (made in the early 1980s) repeatedly. She went to the luncheon club from time totime, but she did not like most members because they gossiped a lot. She went there primarily to gain informationabout social services and to let people know that she was still alive. She thought the workers in the luncheon clubwere basically nice people, but did not feel confident that they had time to help her to solve her problems.Sometimes she went to casinos to see other Chinese people and also because the casinos were warmer than herflat.

Case study 3Mr C, aged 70, was living with his only son in Glasgow. He had run Chinese take-aways for 30 years and hadpassed the business to his son and daughter-in-law. While his son gave him money regularly, Mr C did not feel hisson was concerned about him. He thought that his son looked down upon him because he could not make anycontribution to the family. He was seldom invited to take part in the decision-making process in the family orasked for advice. His son criticised him for being a burden to the family. He suspected his son was planning to sendhim to an older people’s home. He had a grandson, but recently they seldom talked to each other; although hisgrandson knew Cantonese he refused to speak Cantonese to him. As a result, he could not understand fully whathis grandson said. He felt that he was seen as a foreigner, not only in society but also at home. He complained: “Iwas seen as a foreigner in the UK; I understood why the mainstream society did not accept me as a normal person.But I could never understand why my children also regard me as abnormal and do not care about me. Why do theydo this to me?”.

Summary of the interview findings

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Detachment from mainstream society

Quite a number of respondents were using socialand public services. For example, 41 weremembers of luncheon clubs; 27 of whom lived onincome support and 15 who were regularmembers of Chinese community centres. Despitethese, the majority (97) still found it difficult tomeet their needs through the social and publicservices due to language barriers, lack of sufficientinformation and the costs of using social andpublic services.

The majority suffered from language barrierswhen using social and public services (78). Thesenot only arose from their difficulties in speakingEnglish, but also from their difficulties inunderstanding the terms and jargon of the publicand social service system. Of the 22 who did notmention the language barriers, 11 did not use anysocial services at all and 5 relied heavily oninterpreters to help them. However, 19respondents said they did not understand whatthe interpreters were trying to interpret for themin the process of using the services.

Seventy-three respondents did not have clearideas about the types of social services open tothem. Many said that they did not know why theywere given the services that they were using (61).An even large number of respondents (72) haddifficulties in gaining information about socialservices. Twenty-two respondents said that theyhad not received any formal education andblamed this for their lack of ability to understandthe welfare system or express their needs clearlyto the social workers, even in Chinese.

Quite a number of respondents (54) had no ideaabout what kind of social rights they had and thereasons why the government should providesocial welfare for them. This problem is illustratedby the following quotes:

‘‘British are the hosts, we are the guests. Itis doubtless that the services are mainlyprovided for them, not for us.’’

‘‘The government hasn’t looked after mein the past. I don’t believe that it nowsincerely takes care of me. I am old andnot valuable. There is no point in lookingafter me. They provide services just forsymbolic purposes. We are only a dot. ButI still use them because I paid tax andstamps.’’

Twenty-two respondents said that they did notwant to rely on other people (non-familymembers) such as social workers, friends andinterpreters to help them. Twelve respondentscomplained that workers did not treat them well.A respondent said: ‘‘I don’t want to tolerate their(workers’) unfriendly attitude. It doesn’t matterwhether I use more or less services. Dignity is themost important thing to me.’’ Another said: ‘‘Ofcourse, the more services the better. But I hatefilling in forms. I also hate asking people to fill informs for me. If you ask people for help, you willbecome their burden and sooner or later annoythem.’’

Case studies

The following case studies may help to illustratethe difficulties of using public and social services.

Case study 4Mrs D, aged 68, was a member of a luncheon club in London for five years. She was afraid of seeing doctors andsocial workers because she had not mastered any English language. She hoped that the government couldemploy more Chinese workers to visit her regularly and tell her the updated information about social services.

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Some contradictions betweenattachment to the Chinese communityand to mainstream society

It is important to note that attachment to theChinese community may be contradictory to theattachment to mainstream society. Examples areliving in sheltered accommodation and hospitals.When using mainstream social services, Chineseolder people cannot overcome language barriersor mix with other users. Even worse, they mightlose touch with the Chinese community and theirown control over their daily life and diet. As aresult they become isolated individuals insidehospitals and residential housing.

Despite the fact that there is a growing demandfor residential homes, 31 respondents feared thatthey might be required to leave home when usingsuch services as older people’s residential homesand hospitals. In the words of two respondents:

“I am afraid of being sent to an olderpeople’s home because I don’t know howto speak and understand English. I wouldbe seen as an idiot and soon become anidiot.”

“If I live in the older people’s home, I willnot be given the chance to eat the food Ineed. My health will then deteriorate fastand I will die.”

Case study 6Mr F, aged 68, had joined both luncheon clubs and community centres before. He did not find workers friendlyand did not find it worthwhile spending time in these places. He felt that having tea in McDonald’s restauranteveryday was more meaningful. At least he could gain a sense of freedom and did not need to make anycommitment to the centres.

Summary

Given that many respondents had taken part inthe labour market and run family businesses, it issafe to say that many respondents had tried tomaintain certain attachments to the mainstreamcommunity and their own community. However,many now have difficulty in maintaining theattachment to these two communities. Threefocus groups were set up in London to discussthese findings and the possible solutions; thesewill be shown in Chapter 6.

Case study 5Mrs E, aged 70, had no experience of using any public and social services. She was afraid that if she applied for theservices, the government would check her personal information. When she ran the take-away business, she wasalways harassed by the local customers. She did not believe that the government would sincerely provide servicesto meet her needs. Moreover she did not speak or write English and found it difficult to fill in forms. She said:

“I am old now, using some more social services will not make me live longer; they only bring more troubleto me.”

Summary of the interview findings

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15

As discussed in Chapter 1, many problemssuffered by Chinese older people are related tothe problems faced by other members of theChinese community. Chapter 3 showed thatsome Chinese older people do not receivesufficient care from their families. It is not only aproblem faced by older people, but may alsoreflect the limitations of the Chinese as far ascaring for the members of their community. In theChinese family, the main providers are womenand the middle-aged men. Two studies havebeen done to examine their needs, problems andlimitations in taking care of dependants andthemselves.

Chinese women

Background

A study of the social and health needs of Chinesewomen in Sheffield was conducted in 1998.Questionnaires were sent to 140 members oraffiliated members of the Lai Yin Association bypost or by hand. Where assistance was needed incompleting the questionnaires, respondents wereinterviewed by volunteers. The total number ofreturned questionnaires was 87, out of which 85were valid. To counter-check the findings andfurther analyse the insights drawn from the study,ten respondents were invited to discuss the studyresults.

Characteristics of respondents

The majority of the respondents were married(74), four were single and six were divorced. Mostwere aged between 35 and 44 (49). Fifty-nineoriginated from Hong Kong and 23 from MainlandChina. The vast majority had at least attained

primary education (40); 21 had receivedsecondary education and 15 had reachedUniversity level.

Roles of maintaining the family’s health

Most respondents carried out the roles of care andas health providers in the family: 61 didhousework, 64 were responsible for taking care ofchildren and 52 performed cooking tasks in theirdaily activities. Moreover, over one third ofrespondents went out to work, mainly working inChinese take-aways or restaurants. As shown inChapter 2, Chinese women participated actively inthe labour market and this finding reflected thegeneral picture of the Chinese community. Theresponsibilities of respondents for taking care oftheir family and the family business were heavy.More than half of the respondents thought thattheir daily life was either busy or very busy, andnone reported their life was not busy. This washighlighted by one respondent in the in-depthinterview:

“I work from early morning to midnight,the time seems to chase after me. But Ineed to work like that. There is noalternative unless I give up either businessor family.”

Most respondents put family issues before theirown. When being asked to list the things theywere worried about, 54 mentioned the studies/career of their children, 51 health problems oftheir family members and 45 the economicconditions of their family. This shows that mostrespondents regarded keeping their families freefrom these problems as their responsibility.Twenty-seven were even worried about theirfamily members who were living overseas. In the

Chinese women andmiddle-aged men

4

16


in-depth interviews, over half of the respondents(7 out of 10 cases) said that they would feeluneasy and guilty if they were unable keep theirfamily healthy and financially safe. It is thereforenot surprising to see that they were prepared tomake sacrifices to prevent these problems, andthey believed that other Chinese women woulddo the same thing.

On the one hand, respondents were eager tosecure the health of their family members andbore a heavy workload in their daily life. On theother hand, many were far from healthy. Only 33thought that they were either healthy or veryhealthy, 11 thought that they were eitherunhealthy or very unhealthy. It is important tonote that a number of them (41) answered ‘don’tknow’. Moreover, many suffered from commoncomplaints, including headache (35), dizziness(19), backache (28), pain in joints (27), tiredness(27), problems with nerves (26), period paid (26)and feeling under pressure (26).

Language barriers

Fifty-two thought that their English was eitherpoor or very poor. Only two rated their Englishas good or excellent. When asked about whatdifficulties they had come across in using socialservices and health services, over 70% ofrespondents mentioned language barriers.

Cultural gap

Respondents in the in-depth interviews believedthat some health problems were caused byadverse elements inside their bodies, for example,the ‘hotness’ inside the body caused muscle acheand the ‘wind’ inside the body resulted indizziness. Despite the popularity of theseexplanations for illness in the Chinese community,according to the respondents, GPs had noknowledge of them. Even worse, Chinese peoplealso find it difficult to explain these conceptscomprehensively to doctors, even if they have agood standard of English. These concepts werebeyond the understanding of the GPs.

Lack of understanding of the social services

The majority of respondents are immigrants, and itis not easy for them to understand the system ofsocial services and their social rights. Thirty-fivesaid that they did not know that the social andhealth services existed, 39 said that they had no

knowledge about how to use the services and 18felt uneasy about applying for social services tomeet their needs and the needs of their family.

Dual roles

More than one third of respondents needed to goout to work, and many of them ran a familybusiness. As mentioned by Miles (1993), themeanings of health and illness attached byindividuals are influenced by their social standingand material circumstances. This was also foundamong respondents. How they perceived andunderstood illness and health was related to theavailability of resources in maintaining health, andthe necessity of being able to run the familybusiness. Many defined health in terms of theconditions of being able to work. It was commonfor them to claim that they did not know whetheror not they were sick, because they could notafford to be sick or to take sick leave. In mostcases they felt uncomfortable but were ‘able’ tocontinue to work. As a result, they found itdifficult to judge whether they were healthy in areal sense or not.

“Poor people like me have no right tohave illness. If I don’t work, who doesthe work for me in the take-away?”

“If I won the national lottery, I wouldapply for a long sick leave. However,now is the daytime; too early to makesuch a dream.”

Problem-solving patterns

Most respondents were reluctant to seek helpoutside their family. When facing minor problems,41 solved problems with their family members inthe household; when facing serious problems, 45resorted to the wider family network such asrelatives and friends. Few respondents expectedthe government or non-Chinese communityorganisations to help. It is also important to notethat a certain number of respondents solved theirproblems alone – 21 and 10 respondents,respectively, when facing minor and seriousproblems. Forty-five would consult a doctor ifthey or their family members suffered from minorillness, more than one-third of respondents (31)would buy non-prescription drugs from chemists,19 ignored the problems and left the recovery tochance, 13 took Chinese medicine and 6consulted Chinese medical practitioners. If they or

17

their family members suffered from serious illness,most respondents chose to consult doctors (68) orsought help from Chinese medical practitioners(18). However, 11 respondents chose to ignoretheir problems.

Summary

Chinese women not only have limitations inproviding care, but also have similar problems toChinese older people such as language barriers,lack of understanding of social services andproblems arising from the cultural gaps.

Middle-aged men

Background

Besides Chinese women, middle-aged men playan important role in providing care for familymembers. It is therefore important to understandtheir needs, problems and limitations in takingcare of dependants and themselves.


Ten middle-aged Chinese males were interviewedconcerning the problems facing them. Their agesranged from 41 to 55; the average age was 51.Eight worked in the catering industries and twoworked in the commercial field. Five of themwere born in mainland China and five in HongKong. Seven of them had lived in Hong Kongmore than seven years and had come to the UK inthe 1960s.

Eight were married with children and three ofthem lived with their parents. All respondentsidentified themselves as breadwinners and feltthat the financial responsibilities on theirshoulders were heavy. While many did not doany household work, they shared theresponsibility for looking after children.Moreover, they identified themselves as the keyperson for handling serious family crisis. Arespondent said: “Men can’t afford to lose jobs.Even if we don’t need to eat, our family do”.Another said:

“When problems come to our family, nomatter how serious they are, I have toface them. If I don’t sort them out, whodoes?”

Problems

Compared to younger and older generations,middle-aged Chinese people are far moreheterogeneous. There are great variations in theircommand of the English language, theireducational standards and the extent to whichthey mix with mainstream society. However,despite this heterogeneity, most respondentsfaced common problems.

The first problem they face is two types ofgeneration gap. Middle-aged Chinese men needto handle the relationship not only with theirparents but also with their children – theserelationships are complicated by the differentdegree of exposure of different generations toWestern and Chinese culture and values. Thesedifferent values make it difficult to reach aconsensus on how issues are settled in daily life.

“I always worry that my children don’t tellme their problems. However, if they do, Iam not sure if I could understand.”

“I am always blamed by family membersfor using double-standards in handling theissues with my children and my parents.Only when they are in my situation willthey know why.”

For most of the respondents, it was not easy topractise the family values in which they believed.They wanted to maintain the Chinese tradition oflooking after the senior members of the family butfound it difficult to bear the responsibility.Moreover, they were pessimistic that their childrenwould not look after them when they grew old.

The second problem was related to occupationalillness. Six interviewees had experienced minoraccidents in their working places. But few hadclear knowledge about their rights as citizen andworkers, and they found it difficult to use themedical services.

The third problem was uncertainty over theirfuture. Four respondents were the owners ofChinese take-aways and had constant anxietyabout the uncertainty of their business and theyfelt isolated in handling their financial problems.Few had thought about their life after retirement,much less formulated any concrete plan. Theyworried that they might face the same problemsexperienced by the older generations.

Chinese women and middle-aged men

18


Services available to middle-aged men

There were few services specifically targeted atChinese middle-aged men. They seem to besocially non-existent and this, to a certain extent,explains why the middle-aged group provides animportant source of customers to casinos. It is notcertain whether or not they are inveterategamblers. However, they clearly do not havemany places to go other than casinos in theirleisure time. This is especially true for those whowork unsocial hours. Six respondents are regularsin casinos, and besides gambling, they spent mostof their leisure time watching television andstaying with family members. None had joinedany activities in social centres.

Summary

As with Chinese women, middle-aged Chinesemen are not only limited in the care that they areable to provide for family members, but also facea number of personal difficulties in their daily life.

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Introduction

As mentioned in Chapter 3, many Chinese olderpeople found it difficult to attach to their familiesand use social and public services. However, thisdoes not mean that they were unwilling to attachto both their own community and mainstreamsociety. During the interview process, it wasdiscovered that many Chinese older people triedto organise their social networks and gaininformation about social and public systems inpublic places such as McDonald’s fast-foodrestaurants in London’s China Town, casinos andchurches. Examination of the attraction of theseas places where Chinese people go to organiseactivities together will throw insights into thedevelopment of methods for disseminatinginformation about social services and improvingthe attractiveness of social and community centresto Chinese older people. This will also help us tothink about effective methods for enablingChinese older people to take an active role incoping with the difficulties of attaching to theirown community and the mainstream community.

McDonald’s restaurants in London’sChina Town

A number of older Chinese people regularlyspend the whole morning or afternoon inMcDonald’s restaurants. They stay there to meetfriends, gain new information about socialservices, comment on services they have used,share life experience and, very often, simply hangaround repeating the same stories.

Instead of all sitting together, they separatethemselves into small groups, and move from onetable to another occasionally. They seem to have

known each other for quite a long time. They calleach other by nicknames instead of being formal.Many come to the restaurants before or afterjoining activities run by churches, casinos andsocial centres; some prefer to stay only inMcDonald’s and never join other activities. Thereasons for the popularity of McDonald’s fast foodrestaurants in London’s China Town amongChinese older people are discussed below.

Entry and exit patterns

McDonald’s restaurants are characterised byvoluntary entry and exit patterns. Chinese olderpeople can enter and leave the McDonald’sanytime they want without fulfilling any eligibilitytests. Moreover, the cost of entering the service islow. Most only buy a cup of tea and then staythere as long as they want. Some even bring theirown tea to refill.

The setting

The setting of McDonald’s is favourable to theway Chinese people build their networks. Manylike to talk in a group seated at a round table. InHong Kong (where most residents are Chinese),almost all gardens and parks provide tables.Moreover, the seats are often arranged in acircular shape in order to allow people to seeeach other when talking in a group. By contrast,the long benches found in many parks in Londondo not fit their habits so well. This, together withthe unpredictable nature of the English weather,explains why very few Chinese people choose tomeet in parks. Moreover since McDonald’s fast-food restaurants are often occupied by a largenumber of customers, they are noisy enough forChinese older people to talk with a greater sense

Social institutions for socialnetworking

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of security. Even if they talk loudly, they will notbe singled out or attract unwanted attention.

The rules

The rules of McDonald’s are not hard to follow.Chinese older people do not find it difficult toorder tea in English. It is interesting to find thatsome English cashiers can use simple Chinese totalk to them. Although their Chinese is too limitedto enable them to have serious conversations withthe Chinese customers, this friendly gesture issufficient to make most Chinese customers feelwelcome.

Past experiences

As mentioned in Chapter 2, Chinese peopleinvolved in the catering industry have developed,maybe by trial and error, a pattern to provideservices for members of the mainstream society.This pattern emphasises efficiency, predictabilityand quantity. As providers of catering services,they are required to meet these criteria in order tosurvive. This experience enables them to adjustquite well as consumers in fast-food restaurants.

China Town

It is important to note that not all McDonald’s fast-food restaurants attract as many Chinese peopleas do the two near to London’s China Town,illustrating the importance of China Town inattracting Chinese people to meet to organiseactivities together. China Town in London isestablished, not only for meeting the social needsof Chinese people, but also, by its nature, as aninternational tourist attraction designed to provideentertainment. The major role of Chinese peoplein China Town is to provide catering services. Inother words, they are expected to come to ChinaTown to sell their labour as a commodity ratherthan to exercise rights as citizens. Hence thereare inadequate amenities and community facilitiesin which the older Chinese people can spendtheir leisure time. Many retired Chinese peoplewho attach their emotions to China Town findnowhere to stay except in casinos andMcDonald’s.

Casinos

Gambling is prevalent in the Chinese community.Many Chinese including older people spend a lotof time in casinos, and consequently gamble awaya large proportion of their wages every month. Itis important to note that they regard going tocasinos as a part of their life, not necessarilybecause they are inveterate gamblers; theattractiveness of the casinos is also that theyprovide an environment in which they canorganise their social networks.

Almost free entry and free exit

Most casinos operate on a membership systemand, in theory, only members can use theservices. However, they are allowed to bringguests. Admission is free and the applicationprocess usually only takes one day. This simpleand free-of-charge application procedure meansthat casinos are open to almost everybody.Moreover, casinos do not require members tomake any long-term commitment; Chinese peoplecan stop using their services any time they like.

The setting and activities

To attract Chinese people to use the services,many casinos open from the afternoon to earlymorning. Some provide a free Chinese buffet atmidnight every week. Moreover, free drinks arealways available. These services guarantee thatcasinos are not only places for Chinese people togamble but also somewhere for socialising afterwork. Many older people regard going to casinosas a part of their everyday lives. This isparticularly important to those who run the familytake-away business and want to have a breakfrom their family in their leisure time.

The rules

The rules of gambling are simple to follow.Chinese people do not need to take a long time tolearn and it can be done through observation.Although many Chinese customers are not fluentin English, they can communicate with staffmembers without much difficulty through signlanguage and some basic English.

21

Special services

Casinos also provide special services to increasethe sense of belonging for Chinese customers. Itis not uncommon for casinos to provide mahjonggames. Moreover, some send birthday cards tocustomers to make them feel that they are valuedas members.

Nature of services

The services provided by casinos are by naturecommercial ones. In theory customers spendtheir leisure time gambling. However, the amountof money they gamble is unpredictable. It is, ofcourse, possible to win; but, as many regularswould confirm, losing money seems to beinevitable in the long run. Moreover, the amountthey lose on each occasion is also quiteunpredictable. This is not only because the resultis largely determined by luck but also becausesome people may not always make rationaldecisions and eventually gamble away much moremoney than they intended. However, thisunpredictable dimension to gambling activities isseen as part of the excitement; and few makeconcrete strategies for minimising this uncertainty.

Churches

As discussed by Modood et al (1998), manyChinese people are Christians and go to churchregularly. Churches, which serve as importantplaces for Chinese people to meet to organiseactivities have the following characteristics.

Entry and exit

The church is free to enter and open to all. Afterpeople have attended the church regularly for acertain period they will be invited to apply asmembers. The exit is both free and voluntary.

Activities and rules

The main activities in Chinese churches includebible study, singing hymns, praying, offerings andsermons. Although not all older peopleunderstand completely the meanings and theorigin of these activities, it is not too difficult forthem to follow the rules involved. This preventsthem from feeling left out. Moreover, church

members are enthusiastic about helping olderpeople to take part in the activities.

Special services

Many Chinese churches celebrate Chinese festivalsand arrange home visits to older people. Thisserves to strengthen the sense of belonging ofolder Chinese people to the churches.

Summary

This chapter has shown that some types ofsettings are particularly attractive to Chinese olderpeople, and enable them to organise andstrengthen their social networks. Their commoncharacteristics include the absence of entry andexit requirements, rules that are easy to follow,giving older people recognition and a sense ofbelonging, operating at unsocial times of the dayand using the Chinese language as their medium.

Social institutions for social networking

22


23

This chapter discusses some suggestions forimprovements in services for Chinese olderpeople. These suggestions are based on thediscussion of focus groups and interviews withprofessionals. It begins by summarising theproblems faced by Chinese older people andother members of the Chinese communitydiscussed in other chapters.

Five barriers pointed out by the HomeAffairs Committee Report

As mentioned in Chapter 2, the Home AffairsCommittee Report in 1985 has pointed out fivebarriers which block Chinese people fromparticipating fully in British life – lack of English,ignorance of rights, cultural differences, scatteredsettlement and long unsocial working hours. Theprevious chapters show that most of these barriersstill exist to undermine the quality of life ofChinese people, 15 years after the release of thereport.

English

As shown in the interview findings, the majorityof older people had difficulty using English. Thisnot only creates considerable inconvenience intheir daily lives, but also hinders them in usingsocial services effectively and understanding theirrights. One way to solve these problems is toencourage older people to learn English. Duringthe research process, interviewers in Glasgow metsome older people who were enthusiastic aboutjoining an English class in a social centre. Thissuggested that they could not learn as fast asyoung people and their progress was affected bythe deterioration of their memory power.However, they found studying English highly

rewarding. To them, even only picking up a fewsimple English words was already a breakthroughin their lives. Their sense of belonging and theirself-image were improved. More importantly, theexperience of taking English lessons broke themyth that they could not learn.

However, to cope with language barriers, simplyrelying on the efforts of Chinese older people tolearn English is not sufficient. Professionals alsohave a responsibility for learning how tocommunicate with them by studying theirmethods of using English and by learning someChinese.

Sense of rights

As shown in Chapter 3, just over half of therespondents (54 out of 100) had no idea abouttheir rights and the reasons why governmentprovides social welfare for them. This includesthe regular users of public and social services. Anumber of them still thought that their entitlementto a service and how much they would receivedepended on the goodwill of the professionals.Some were worried that they would no longer begiven services if their relationship with workersturned sour. It is therefore necessary to promotein older people a sense of rights with particularfocus on the current development of governmentpolicies, their rights and the use of the differentcomplaints channels.

Culture

The report stressed that the Chinese community ischaracterised by self-help virtues, thus Chinesepeople tend to help themselves and rely on theirfamilies rather than on public and social services.As shown in Chapter 3, many older people had

Promoting double inclusion intwo communities

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mixed feelings about families. On the one handthey thought that family care was the best type ofcare and hoped that their children would lookafter them. On the other hand, more and moreolder people realised that their children wereeither unwilling or unable to take care of them.Clearly there is a widening gap between olderpeople’s expectations and the actual caringcapacity of their families. More social servicesshould be provided to meet the needs of Chineseolder people while encouraging them to placemore expectations on social welfare.

Scattered settlement

The scattered settlement remains a seriousproblem. Chapter 2 shows that those Chinesepeople living in smaller towns, including olderpeople, and those with lower mobility had lesschance of using community facilities and socialservices.

Unsocial hours

As shown in Chapter 3, a number of older peopledid not receive sufficient support from theirfamilies because their family members needed towork long and unsocial hours in the Chinesecatering industry.

Problems overlooked in the HomeAffairs Committee Report

The previous chapters discovered that there areseveral issues overlooked by the Home AffairCommittee Report, including the following.

The middle-aged group

As shown in Chapter 4, the middle-aged groupplay an important role in providing care to olderpeople, but they themselves also face a number ofproblems – the two levels of generation gap (gapswith their parents and gaps with their children),working unsocial hours, occupational hazards,little knowledge about their social rights andsocial knowledge, language barriers anduncertainty about their future.

Mental health

The report mentioned the difficulties of helpingChinese people with mental problems. However,

it did not give the necessary details of thesolutions to the difficulties. Studies show thatmany Chinese people with mental problems donot receive sufficient attention (Au and Siew,1997). Approaches to helping them are marked byserious defects. As shown in Chapter 2, oneexample is the ‘dumping approach’. Thisapproach is founded on the principle that Chinesepeople know their own problems better and aretherefore in a better position to solve anyproblems in their community. This approachencourages Chinese people with mental illness toseek help from Chinese organisations, regardlessof their aims and functions. This approach suffersfrom a number of defects – the over-estimation ofthe caring capacity of the Chinese community,giving excuses why professionals are notimproving the methods of helping Chinesepeople, and over-emphasis on the homogeneity ofChinese people with mental illness.

Eight Chinese people who had recovered frommental problems were interviewed in Glasgowand London, six of them were older people. Itwas found that they faced extra difficulties inleading a life with dignity and security. Theyneeded to re-establish their life, not only in thehost society, but also in their own community,which had little understanding about mentalillness. Moreover, they found it difficult to getback to work even after recovery and, as a result,were forced to take early retirement. It isimportant to note that work is seen as animportant part of normal life in the Chinesecommunity. Chinese people of working age arevulnerable to stigma if they are either unwilling orunable to work. People who are recovering frommental problems and who cannot find a place inthe labour market not only have too much timeon their hands but also have their self-imagedented. Support for them from the family shouldnot be taken for granted. Two respondents in thisstudy were unmarried and lived alone andanother had difficulty in getting along with familymembers. On the one hand, they needed to relyon their family members to look after them while,on the other hand, they complained that theirfamily members exercised too much control overtheir lives. This ‘close but uneasy’ relationshipput pressure not only on them but also on theirfamilies. Furthermore, most found it difficult tocommunicate with medical professionals or tounderstand the treatment they had received. Thisis due not only to language barriers but also to alack of knowledge about the medical system.

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Interpretation services

Since many Chinese people do not knowsufficient English, the report stressed theimportance of expanding interpretation services tohelp them to use social services. However, theinterpretation services are an essential butinsufficient means for Chinese people to copewith language barriers. Many Chinese churchesand community centres provide free interpretationservices to help older people to see GPs and touse other social services. However, there is noguarantee that the interpreters are able to helpolder people to express their ideas to theprofessionals or allow them to understand theviews of the professionals. Moreover, it is alsoimportant for Chinese people to know how towork with interpreters, and for the interpreters tobe accountable to them. However, the report didnot make any suggestions on this issue.

Medical and health services

The Home Affairs Committee raised concernabout the under-use of health and medicalservices. It made a number of suggestions on theimprovement of the accessibility of health servicesto Chinese people. However, it did not examinein detail whether the conventional health andmedical services were effective in helping Chinesepeople, or whether the costs were paid byChinese people. Nor did it explore the possibilityof helping Chinese people to maintain their healththrough their own methods – such as subsidisingthem to use traditional herbal medicine andservices from Chinese medicine practitioners.

Continuing education for older people

The section of the report on education mainlyfocused on the needs of younger people. Theneeds of older people for lifelong education wereneglected. There was also an absence ofdiscussion about how to develop the potential ofolder people to contribute to their family and thecommunity.

Suggestions from Chinese older people

Eighteen Chinese older people in London wereinvited to join three focus groups to discuss thepreliminary findings of the semi-structuredinterviews shown in Chapter 3 and Appendix B,and made suggestions on the improvement of

their political, social and economic positions.Two focus groups were held in McDonald’s fastfood shops in London’s China Town and one at aChristian fellowship in London’s China Town.Their suggestions fall into five categories: toimprove Chinese older people’s participation inthe service-providing and service-receivingprocess; to arouse concern regarding their needsand problems from their own community and themainstream community; to improve their access toservices; to help them to build a higherexpectations of their lives in the UK and thecaring services; and to provide opportunities forlife-long learning.

To promote participation in the service-providingand service-receiving process

• Organise a national forum to promote therights of Chinese older people and to voicetheir demands for caring services.

• Set up fact-finding and inspection teams ofChinese people to assess formal caringservices for Chinese older people.

• Discuss with professionals how to improvecommunication and develop an effective andequal relationship in the care-giving and care-receiving process.

• Develop a training package from a users’perspective for training professionals to meettheir needs.

• Provide more opportunities for them to take anactive role in the interpretation process; forexample, to help them understand the roleplayed by interpreters and their limitations inthe interpretation process.

• Teach them to use the complaint systems forformal caring services.

To arouse concern over their needs and problemsfrom both the mainstream community and theirown community

• Give them the right to choose their own dietsin residential homes.

• Provide more ‘walking wardens’ to visit them.• Help them solve their family problems such as

generation gaps and the difficulties incommunicating with the grandchildren, and tomake their families aware of their needs andproblems.

Promoting double inclusion in two communities

26


To strengthen the access to services

• Provide more social and community services inChina Towns (such as in London andManchester) where many of them spend theirleisure time almost every day.

• Subsidise their purchase of Chinese herbalmedicine and consultation with Chinesemedicine practitioners.

• Provide more residential homes.• Run courses to teach them to fill in application

forms for social services.• Open social centres at unsocial times.• Expand interpretation services and sponsor

their family members to receive interpretationtraining.

• Employ more bilingual workers in the formalcaring services.

• Provide Chinese television programmes topromote caring services.

• Provide hot-line services for them to enquireabout social services and to discuss theirrights.

To build higher expectations

• Subsidise their travel to different cities andvisits to different Chinese communities.

To promote lifelong learning

• Provide them with opportunities for learningEnglish and other languages.

• Provide more skill training programmes tohelp them to find jobs.

Suggestions from professionals

As mentioned above, professionals were invitedto make suggestions on the improvement of theolder people’s political, social and economicpositions. Further details of the professionals aregiven in Appendix A.

To promote participation in the service-providingand service-receiving process

• Encourage Chinese older people to take part involuntary work (for example, to ask them toteach cooking skills, Chinese culture andChinese languages in community centres).

To arouse concern over their needs and problemsfrom both the mainstream community and theirown community

• Make the public aware of the importance ofpromoting mental health and the Chinese wayof defining and expressing mental illness andmental health.

• Invite active users of caring services to act asexemplars to encourage more Chinese olderpeople to use caring services to meet theirneeds.

• Encourage interpreters to develop commonterms for interpreting the health concepts ofChinese older people.

To strengthen the access to services

• Provide more opportunities for all Chineseolder people to join luncheon clubs.

• Set up information counters for promotingformal caring services in the Chinese people’smeeting points such as casinos, McDonald’srestaurants in London’s China Towns and inchurches.

• Establish ‘sales’ teams to take a pro-activeapproach to contacting Chinese older peopleindividually to introduce formal caringservices.

• Teach Chinese older people to use emergencyservices, such as alarm bells at home, beforethey face a crisis.

• Run more case conferences to share theexperiences and skills for meeting the needs ofChinese older people with mental illness.

• Provide more outreach workers to identify andmeet the needs of housebound older people.

To build higher expectations

• Help Chinese older people to have a morepositive evaluation of their working life andhigher expectations of their retirement.

• Provide opportunities for them to contact olderpeople of other ethnic groups to enable themto understand their common needs and rights.

To promote lifelong learning

• Provide training courses for both Chinese olderpeople and middle-aged groups to prepare fortheir retirement, and to understand the welfarerights of those who are retired.

• Invite Chinese older people to teachprofessionals about Chinese culture and theirways of defining and meeting needs.

27

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One hundred interviewees were invited to takepart in the research process, 45 from London, 25from Glasgow and 30 from cities in Yorkshireincluding Rotherham, Doncaster, Sheffield andBarnsley.

The Chinese community in London is quitedifferent from the Chinese communities inYorkshire and Glasgow. The former is marked bya high concentration of Chinese people in ChinaTown, which provides not only a place forChinese people to earn a living but also a meetingpoint for them to organise their informalnetworks. By contrast, Chinese people inYorkshire and Glasgow are more scattered. Theydo not have China Towns to serve as theirmeeting points. Moreover, the owners of Chinesetake-aways tend to isolate themselves from eachother in order to avoid competition. Hence it isnecessary to study all these three Chinesecommunities to increase the reliability of thestudy.

The number of older Chinese people referred byagents (volunteers, deacons, community workersand committee members of voluntaryorganisations) were as follows:

London: 5Glasgow: 4Cities in Yorkshire: 6

The number of older Chinese people contactedand interviewed in the public placeswere as follows:

London: 40Glasgow: 21Cities in Yorkshire: 24

The interviewers visited a number of public placesto contact interviewees, including the following:

London: Christian fellowship (1),McDonald’s restaurants(2), casino (1) and parks(2)

Glasgow: Social centre (1), councilhousing area (1), fast foodrestaurant (1), casino (1)and shopping centre (1)

Cities in Yorkshire: Luncheon club (1), Church(1), fast food restaurant (1)and casinos (2)

Eighteen Chinese older people in London wereinvited to join three focus groups to discuss thepreliminary findings of the semi-structuredinterviews, and made suggestions on theimprovement of their political, social andeconomic positions. Two focus groups were heldin McDonald’s fast food shops in London’s ChinaTown and one in a fellowship in London’s ChinaTown.

Twenty professionals were invited to makesuggestions for the improvement of the olderpeople’s political, social and economic positions.They include community workers (3), workers inluncheon clubs (4), home-help workers (4),social-work students (2), committee members ofChinese organisations (4) and deacons in theChinese churches (3).

Appendix A: The researchmethod

A

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B

One hundred Chinese older people wereinterviewed. The aim of the interviews was toexamine the care needs of Chinese older peoplefrom their own perspective. The interviews wereconducted in the interviewees’ own languages,which were mainly Cantonese, Hakka andMandarin. To provide more opportunities forinterviewees to share their views to the caringservices and their life in the UK, a semi-structuredapproach was used. Four core questions wereasked in all interviews, including:1. Can you share your experiences of using care

services in the UK?2. What are the criteria for good care services?3. What are your suggestions for improving your

social and economic position?4. Do you feel happy about living in the UK?

Besides these four questions, a number of issueswere discussed with interviewees, including theirmigration history, perception of health, financialplans, family, cultural identity, views on theirhomeland, the government and older people ofother ethnic groups. Some interviewees took theinitiative to discuss other issues such as the statusof Chinese medicine, the uncertainty of theirfuture, and the generation gaps and problemswith their grandchildren.

This appendix presents the characteristics ofrespondents and the findings.


Thirty-nine respondents were male and 61 werefemale. The average age of interviewees was 71,the oldest was 84 and the youngest was 65. Theplace of origin of the majority (72) was HongKong. Twenty-seven came from Mainland China,

of whom eight had stayed in Hong Kong for morethan five years before arriving in the UK, and onewas born in Singapore. Fourteen intervieweesarrived in the 1950s, 35 in the 1960s, 39 in the1970s, 10 after 1980. Two interviewees hadreturned to Hong Kong but had come backrecently.

Sixty-eight interviewees had worked in the UK, ofwhom 50 had worked full-time and 18 had beeneither part-time or temporary workers. Nine saidthat they had never been employed formally buthad helped out in their family’s take-aways fromtime to time, receiving no wage. The other 20disclosed that their main purpose in coming to theUK was to take care of either their children orgrandchildren or both.

Of the interviewees who had worked before, 60had worked either in Chinese take-aways orrestaurants. Four worked in Chinese shops andfour did not disclose the details of their careerhistory. None of them had worked in the cateringindustries before coming to the UK. Many whocame from Hong Kong used to be farmers livingin rural areas – the New Territories (35). The restused to work in other occupations such as factoryworkers, bus drivers and construction workers.

Improvement of their material standard of livingwas the main reason for interviewees to come tothe UK. This is especially true for those whoarrived in the early 1960s. The second mostimportant reason was family reunion. Eightinterviewees who came from mainland Chinamentioned that they moved to the UK becausethey did not want to live under communist rule.

Fifty-seven interviewees spoke Hakka as theirmother-tongue, the rest of them spoke Mandarin,Hokkan, Tai-Shang or Cantonese. Eighty-one

Appendix B: Interview findings

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interviewees could speak or understandCantonese without difficulty. Over 30interviewees started learning Cantonese aftercoming to the UK because of the need to look forjobs and make contact with other Chinese people.Six could understand English. Only three couldspeak fluent English. The rest of them haddifficulties in using English in daily life. Eightinterviewees had joined English classes but didnot find it very useful in improving their languageskills. At the time of the interviews, threerespondents were studying English at a socialcentre.

Self-perception of health

When asked to comment on their state of health,almost 40 say that their health was good or verygood; 22 said their health was poor. The rest ofthem thought that their health was fair. It isimportant to note that over half of therespondents (55) described their mood as a littlesad or very sad most of the time. Over one thirdthought that their future was full of uncertainty.

Dependency on other people indaily life

The majority of interviewees could take part inmost of the activities of daily living without thehelp of other people, such as bathing (94),washing hair (94), dressing (94), getting in andout of bed (96), preparing meals (88) andshopping (82). However, many had difficulties inusing the public and social services, managingrepair work on their houses (42) and travelling onpublic transport (52).

Sense of financial security

Thirty-eight respondents lived on benefits; 33were receiving pensions, 13 relied on financialsupports from their children and the rest refusedto talk about their financial situations. Themajority (68) said that the amount of money theyreceived was sufficient to maintain a living.Thirteen respondents said that their financialsituation was much better than those older peopleliving in Hong Kong. However, 14 complainedthat they had too little money to support a decentstandard of living. It is important to note that over15 interviewees (including both relying on

benefits and pensions) worried that they might beprohibited from receiving money in the future.Twenty-five mentioned that they had not realisedthe importance of the pension scheme before theyretired.

Family as a supportive and caringsystem

A majority of interviewees (71) thought that thefamily was the best institution for providing carebecause carers in the family know theirdependants well and give them emotionalsupport.

Moreover, they had a strong emotional attachmentto their family and children. When asked whatthey wanted their children to do and to have, theygave the following answers: to have a happy life(52); to respect and support their parents (43); toachieve some success in their careers (21); tohave a happy family (31); to be good parents(48); to get away from the catering business (8);to be healthy (39); to see them occasionally (41);to reach a good level of academic achievement(5) and to continue their take-away businesses(7).

Furthermore, some of those who lived with theirchildren took an active part in family activities,such as doing the household chores and takingcare of children: taking part in the family cateringbusiness (6); looking after grandchildren (7);carrying out household chores (10); preparingmeals (4); and carrying out maintenance on thehouse (3).

The actual performance of families in providingcare for the respondents

Sixty-five did not have high expectations of theirfamily members taking care of them for fourreasons: poor relationship with the familymembers, depreciation of Chinese traditionalvalues, pressure faced by their children and lowself-image.

First, many interviewees lived alone (39): 15 werenever married; 11 were either widows orwidowers with no children. Thirteen wereseparated from their spouses and children due toa number of reasons – marriage problems, healthproblems and financial problems. Twenty-twolived with their spouses but not with their


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children. Nine have not seen their children overthe past two years, of whom six did not knoweither the address or the phone number or both oftheir children. Seven saw their childrenoccasionally, mainly at times of festivals, theirbirthdays and when they had problems. The rest(39) lived with or very close to their children.

However, living together was not a guarantee ofgood relations. The common factors underminingtheir relationship with children included thefollowing: the children worked long hours andhad no time to talk to them (16); they did notknow whether they were hosts or guests in thefamilies (12) and this put them in an embarrassingsituation in the family decision-making processand in the events which required sharing financialresources; they were worried that they wouldbecome a burden to their families (8); and theydid not understand English and could notcommunicate with their grandchildren (7).

Second, 22 were not quite sure whether Chinesetraditional values could still be applied in theChinese community in the UK, as the youngergenerations were influenced more by westernculture. Some respondents often used theincidents of abuse of older people in Hong Kongto justify that their situations were not as bad asthey might have been.

Third, 29 interviewees thought that their childrenfaced a lot of pressure in their daily lives, such ascompetition in the catering industry, the need tolook after their own children and difficulties usingmainstream services. They therefore did not thinkthat their children had sufficient time or resourcesto meet their needs.

Finally, 25 interviewees thought that they were nolonger useful or valuable in the family now thatthey had lost the ability to contribute to the take-away businesses or to look after theirgrandchildren.

Experience of formal caring and socialservices in Britain

The social and public services used byinterviewees included the following: incomesupport(37); disabled allowances (12); home-helpservices (7); visiting wardens/support workers (4);sheltered housing (8); luncheon clubs (41);.

Chinese community centres (22);. council housing(20) and mental hospitals (6).

Many respondents used more than one kind ofservice. For example, 15 members who went toluncheon clubs regularly were also the membersof local Chinese community centres. Twelve wholived in council housing were also on incomesupport. Eight did not use any services.

Views on social and other public services

Social and public services are important means forolder people to meet their needs and to achieve ahigher quality of life. Only three intervieweesthought that it is easy to use public and socialservices. Ninety-seven respondents found itdifficult to use the services. The difficulties areexplained below.

Language barriers

The majority suffered from language barrierswhen using social and public services (78). Thesenot only arose from their difficulties in speakingEnglish but also from their difficulties inunderstanding the terms and jargons of the publicand social service system. Of the 22 who did notpoint out the language barriers, 11 did not useany social services and 5 thought that theinterpreters had helped them a lot inunderstanding the requirements and benefitsprovided by the social and public services.However, at the same time, 19 did not understandwhat the interpreters were trying to interpret forthem in the process of using the services.

Information about social and public services

Seventy-three respondents did not have clearideas about the types of social services availableto them. Many said that they did not know whythey were given the services that they were using(61). Fifty-four said that they were not surewhether they had the right to use them. Anequally large number of respondents hadexperienced difficulties in gaining informationabout social services (72).

Twenty-two respondents said that they had notreceived any formal education and blamed this fortheir lack of ability to understand the welfaresystem or express their needs clearly, even whenspeaking Chinese to Chinese workers.

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The costs of using social and public services

Almost one third of respondents (31) feared thatthey might be required to leave home when usingsuch services as older people’s residential homesand hospitals. In the words of two respondents:

“I am afraid of being sent to olderpeople’s home because I didn’t know howto speak and understand English. I wouldbe seen as an idiot and soon become anidiot.”

“If I live in an older people’s home, I willnot be given the choice to eat the food Ineed. My health will then deteriorate fastand I will die soon.”

Twenty-two respondents said that they did notwant to rely on other people (non-family) such associal workers, friends and interpreters to helpthem. Twelve respondents complained thatworkers did not treat them well. A respondentsaid: “I don’t want to tolerate their (workers’)unfriendly attitude. It doesn’t matter whether I usemore or less services. Dignity is the mostimportant thing to me.”

The criteria for good practices in caring services

Corresponding to their views on social and publicservices, they have listed a number of criteria forgood practice: the services should be set up in away that causes no embarrassment in using theservices; the carers should really understand whatis being said; the services should not create toomuch work for family members, friends andcommunity; the services should be able to solvecrises effectively; there should be no need to fillout forms; there should be a specific service tounderstand needs and problems; there should beabsence of discrimination against those not onbenefits; and there should be provision formembers of the community to live within theirown community.

Their views of their current lifein the UK

The respondents’ views of their current life in theUK are far from homogeneous. They can becategorised into four types.

Respondents who did not want to talk

Ten respondents said that they had no interest inevaluating their life in the UK for the reasonssimilar to the view shared by Mr G:

“I have spent half of my life in the UK. Itis no use talking about it now. Eventhough I don’t enjoy living here, I can’tleave. If I could turn the clock back, Iwould think about living in other places.But since this is not possible, it is betternot to think about making any changes.The more I think about it, the more I willfeel unhappy about my life. Nobody likes,I think, to spend their whole working lifein a kitchen if they have choices. I am oldnow, I have to accept life as it is. I don’twant to be an annoying old man obsessedwith making complaints.”

Positive views

About one third (30) thought that their life in theUK was better than their place of birth (HongKong and China). The advantages of living in theUK include having better quality of air, living inlower density areas, enjoying a greater chance ofearning a living and knowing more about theworld.

Moreover, a lot of respondents thought that at thetime when they left Hong Kong, they had nochoice at all. A respondent said: “Because Ineeded to survive (economically), I needed tolook for jobs outside Hong Kong.” Since theythought they started from nothing in the UK, theysaw anything they have gained as a bonus.

Negative views

However, 35 respondents had negative views ontheir life in the UK. These include:

• Life in the UK is boring and the daytime is toolong (25).

• Living in the UK means speaking a second-class language and being given only second-class citizen status (30).

• Some respondents mentioned that they werenow waiting for three things: “waiting to eat,waiting to sleep and waiting to die” (22).

• Some described themselves as “half deaf andhalf blind” because of language barriers (21).


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Conditional views

The rest of the respondents said that whethertheir life in the UK was good or not depends oncertain conditions. These views could berepresented by the following quotes:

“As long as I could sleep well, eat welland are able to walk, I feel that life in theUK is good.”

“If my family is healthy and happy, I willbe healthy and happy.”

“There is nothing good or bad. As long aspeople give me more consideration, I willfeel better.”

“Life is good in the UK and even better if Icould win money in casinos.”

Although some did not like their current life in theUK none had concrete plans for going back totheir place of origin for five reasons: they couldnot afford to buy a flat in Hong Kong; many oftheir friends had either died or lost touch withthem; the difficulty of finding new friends;travelling is too tiring and expensive; and thepolitical status of Hong Kong has changed after1997.

Interviewees’ life goals

To further understand the respondents’ attitude toan ideal life and their views on their current lives,respondents were asked about their goals.However, one third of respondents were unwillingto discuss their goals because they thought it wasno use talking about them. Those who did gavethe following views: to have a sense of peace(25); to have a stable family (21); to have childrenwho fulfil their own expectations (25); and tohave a life free from crises (23).

Comparison

No interviewees compared themselves with olderpeople of other ethnic groups. Sixteeninterviewees compared the services they wereusing with those provided for older people inHong Kong. Ten in Yorkshire and Glasgowcomplained that they received less services thanChinese people in London and Manchester. As

mentioned before, quite a number of older peoplefelt that living in the UK was good because it wasmuch better than living in Hong Kong.

Their impression of how they areviewed by others

Respondents were asked to describe how theywere seen by others. Their answers showed thatthe self-image of many of them was low. Overhalf of them (65) thought that they were seen as‘useless’ and ‘burdens’ because they no longermade any contribution to society and their family.As mentioned above, 12 thought that they wereregarded as second-class citizens as they couldnot speak English and understood very little aboutthe social systems. Only a few (7) thought thatthey were treated as citizens and enjoyed thesame rights as members of the mainstreamsociety.

chinese older people policy... · is indebted to mr alex o’neil and dr emma stone of the...

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