CHAPTER 9

Summary and Implications

This study sought to examine how rapid socio-political-economic changes

since 1949 have influenced everyday intergenerational practices in rural
China and how shifts in intergenerational practices have affected the care
given to elderly parents by their adult children. Primarily, the study exam-
ined how villagers themselves see the impact of social change on intergen-
erational relationships, elderly care, family cohesion and the traditional
value of filial piety. In this chapter, I summarise the major findings of the
study, and discuss policy implications for the Chinese government for aged
care, and recommendations for future research.

9.1   Summary of Major Findings

The five major findings of this study can be summarised as follows:

1. Contrary to the argument that filial piety is declining rapidly in con-

temporary China (e.g. Siu, 1993; Yan, 2003), it remains the domi-
nant family value in Dougou. Most elderly parents there regard their
own children as dutiful. Filial piety is still a key norm of social behav-
iour in Dougou. Moreover, it is still significantly associated with face
or reputation in the local community, which can profoundly affect
villagers’ lives, especially those of men.
However, at the same time, this traditional value has undergone
transformation. Elderly parents and adult children have both

© The Author(s) 2019 177

F. Cao, Elderly Care, Intergenerational Relationships
and Social Change in Rural China,
https://doi.org/10.1007/978-981-13-2962-3_9
178 F. CAO

r­edefined it, and adjusted their expectations and behaviours in

response to the changing economic and social conditions in China,
as several other studies also report (Li, Long, Essex, Sui, & Gao,
2012; Luo & Zhan, 2012; Qi, 2016; Zhan, Feng, & Luo, 2008). In
Dougou, traditional notions of submission and obedience to par-
ents have been largely abandoned; today, filial piety is more related
to providing material and emotional support for parents, as found
by Qi (2016).
These continuities and changes are consistent with the findings of
Georgas, Berry, and Kagitçibasi (2006) in their questionnaire-based
study of family and social change in 30 countries. They found that
one of the major family changes under the influence of industrialisa-
tion and urbanisation is a decline in patriarchal power within the
family, and this has occurred in high-, middle- and low-income
countries. However, they note that ‘family values related to main-
taining relationships with family members and kin have changed
much less than hierarchical roles within the nuclear family’ (Georgas
et al., 2006, p. 237).
Similarly, changes in hierarchical roles in rural Chinese families
have reduced the element of submission and obedience to one’s
parents, whereas as a traditional family value bonding the genera-
tions, filial piety remains prevalent and persistent. According to my
participants, reverence, once a critical element in filial piety, is not as
important as it was in the collective period. Evidence of this reinter-
pretation is that some adult children who scold their parents are still
seen as dutiful by their parents.
2. There is evidence for both strong family bonds and increasing
desires for individuality and autonomy amongst Dougou villagers.
Family bonds between the generations remain strong, and family is
still the main source of financial, emotional and social support for
villagers. Geographically separated elderly parents and their adult
children still make frequent contact with each other, through tele-
phone calls and travel, as has been found by several studies that
observe the maintenance of emotional closeness of families across
geographical distance (e.g. Georgas et al., 2006; Landolt & Da,
2005). In particular, Georgas et al. (2006, pp. 233–236) observed
that ‘emotional bonds were the most robust universal’ in the 30
countries where their teams conducted the research, and that emo-
 SUMMARY AND IMPLICATIONS 179

tional closeness is related neither to the socio-economic d ­ evelopment

of the country nor to whether families live apart from each other.
Furthermore, Dougou villagers still cooperate with family mem-
bers in aspects of childcare and elderly care, often across geographi-
cal distances. Villagers still rely heavily on their families for financial
support, due to the lack of other resources, including bank loans.
Family obligations remain significant. Migrant workers save for
decades to fulfil their obligations to help their sons to establish their
families. I found numerous examples of villagers making sacrifices
for their families, for the needs of their children, their spouses and
parents. It is true too for the young migrant workers (aged in their
20s), who told me that they are working hard to provide more
financial support to their parents and create better living conditions
for their children. Because of the lack of quality education resources,
well-paid work and sufficient old-age pensions, among other things,
not only the elderly but also the young and middle-aged rely on
their families for all kinds of support. As Barbalet (2016) argues,
migrant work itself demonstrates that rural migrants are performing
family obligations, and the decision-making process involved in tak-
ing up migrant work is at the same time a process through which
they try to make the best of opportunities to meet the family’s
needs. Evidence of this is that parents in Dougou with several sons
generally need to work more years than parents with only one.
In Dougou, it is also true that the desire for autonomy and indi-
viduality is on the rise. For example, the recent phenomena of elderly
widows and widowers making efforts to remarry, to ‘find an old man
or old woman’, that began in the first decade of the 2000s, and early
household division both indicate rural people’s increasing desire for
autonomy. Early household division was regarded as a symbol of the
decline of filial piety in Wang’s (2004) study, and it is true that in
rural China it has become more commonplace and acceptable for
elders to live separately from their sons and daughters-in-law
(Thøgersen & Ni, 2008; Wang, 2004). Yet, to attribute early house-
hold division to the weakening of filial piety is problematic. Although
many elders choose to live separately as a result of irreconcilable
intergenerational conflicts, some participants in my study said that
they themselves initiated the separation as a means of gaining more
autonomy, and that they enjoy living separately, a finding also sup-
ported by Thøgersen and Ni (2008). In addition, Zhang (2004)
180 F. CAO

found that rural elders reported improved well-being in both mental

and physical health after deciding to live alone. The elderly parents’
increasing desires for autonomy is clearly a cause for the phenome-
non of early household division.
According to Kagitçibasi (2006), many psychologists acknowl-
edge that autonomy and relatedness are the two main human needs.
In Dougou, family bonds and the desire for individuality and auton-
omy are two social forces standing in tension with each other. For
some villagers, ‘individual autonomy is attained but not at the cost
of relatedness with close others’ (Georgas et al., 2006, p. 238).
However, the tension between these two forces has caused disquiet
for other elderly parents and their adult children. It is common for
adult children to worry about their parents when they are not physi-
cally present to care for them. Some adult children feel guilty about
not being able to perform their care responsibilities well enough,
while some elderly parents living alone said that they are worried
about the future, when they will be dependent.
3. The individualisation thesis, widely applied to explain the contem-
porary social and family changes in China, overlooks continuities in
family values and practices, and the range of structural constraints
on the individuals, particularly migrant workers. The application of
the individualisation thesis in the Chinese context has particularly
overlooked the unequal social structures and China’s family-based
culture. In Dougou, rural villagers have limited opportunities indeed
to ‘write their own biography’: middle-aged migrant workers are
under economic strain to save enough for their adult sons’ wed-
dings, the younger generation still relies on parents for establishing
their families and elderly villagers often rely on their adult children
for various kinds of support. Villagers generally still adhere to the
traditional family value of ‘looking after one’s family-of-origin’, usu-
ally expressed through financial support. The local expression that
‘we are all on the same coin string’ (women dou zai yige qianchuan
shang, 我们都在一个钱串上) is further evidence of this family value,
which means that financial difficulty for one member in the extended
family is difficulty for all, while fortunes for one member benefit the
whole family. The individualisation thesis clearly does not explain
these phenomena in rural communities. The aforementioned phe-
nomena show the connections and relatedness in families, the effects
of social constraints on individuals and the ‘linked lives’ across
 SUMMARY AND IMPLICATIONS 181

­ enerations, or, in terms of the perspective of Gross’ ‘two tradi-

g
tions’, the persistence and integrity of the ‘meaning-constitutive’
tradition.
Yet, the claims of individualisation theorists can be interpreted as
the decline of the ‘regulative’ tradition. No population group in
Dougou, including the elderly, lives as it did traditionally, before
1949 or during the collective period. As Smart and Shipman (2004,
p. 507) note, ‘what traditions “are” and what they mean is also seen
to be negotiable and subject to change’. In the context of changed
social and economic life, patriarchal authority, hierarchical gender
relations and constraints on the individual have declined in impor-
tance. Villagers are nowadays not confined to the traditional way of
life. Women have more power, and thus as daughters-in-law they are
empowered to be dutiful to their own parents instead of their
parents-­in-law. Previous requisites for filial behaviour, such as co-­
residence with elderly parents and absolute respect and obedience
towards parents, have largely disappeared, and filial piety today is
more often expressed through material support.
4. Elderly villagers are the victims of China’s socio-economic-political
change. Their status is declining steadily in parallel with their declin-
ing capacity to contribute to the family income, especially in the
migrant work era. This declining status has affected their lives in
many ways. In general, elderly people in Dougou live marginalised
lives. Although their living conditions have improved in real terms
since the collective period, they are now poorer than the younger
generations in terms of accommodation, food and other consumer
items. It was agreed by all with whom I discussed this topic that the
elderly do not need a contemporary lifestyle like that of the younger
generations, because they have different interests, needs and finan-
cial resources.
Yet, in daily life, many elders of Dougou repress their needs, avoid
causing trouble for their sons and daughters-in-law, and do their best
to help with housework and childcare for their sons and daughters-
in-law. The roles of the mothers and daughters-in-law are now the
reverse of what they were in the collective period, as also found by
Wang (2004, p. 29). Commonly, mothers provide daily services to
their sons, daughters-in-law and grandchildren. This phenomenon is
interpreted by Ikels (2004) and Miller (2004) as the elders’ efforts to
increase the indebtedness of their sons and daughters-­in-law, thus
182 F. CAO

ensuring they will receive the care they will need later. Yang and
Chandler (1992, p. 451) point out that the phenomenon is also due
to the traditional Chinese attitude of sacrificing one’s own comforts
to ensure a better future for one’s children. Some scholars (Chen,
2004; Cohen, 1992) also attribute grandparental contributions to
domestic labour to the continuity of the Chinese ‘corporate family’—
family members of the two generations cooperate to maximise family
income (thus grandparents who are less competitive in the employ-
ment market stay at home doing housework and childcare). These
interpretations were borne out by my study.
Regarding this phenomenon of reversed roles for mothers and
daughters-in-law and the ‘submissive’ behaviours of the elderly par-
ents, my study also provides insights from the examination of the
increasingly heavy economic burdens on middle-aged parents.
Several elderly participants said that they repress their own needs
and help with domestic work in order to reduce their sons’ eco-
nomic burdens. The sons and daughters-in-law must in turn accu-
mulate enough wealth for their own sons’ marriages. Care for the
elderly parents is profoundly affected by the increasingly heavy bur-
dens on middle-aged adult children. The financial resources of
­middle-aged parents flow downward for the sons’ marriages, thus
making it impossible, in some cases, to provide the care for their
own parents that they see as sufficient.
Some scholars argue that the marginality of rural elders is the
result of the decline of filial piety and the rise of individualism (e.g.
Siu, 1993; Yan, 2003). However, my study suggests that the (rela-
tively) deprived situation of rural elders is more the result of their
limited resources vis-à-vis other groups in the population. Elderly
villagers receive very limited state pensions and insufficient support
in areas such as medical care. Rural elderly people are especially dis-
advantaged considering the growing affluence of the Chinese econ-
omy, as other population groups (both in rural and urban areas)
possess significantly more resources than the rural elderly.
5. Migrant work poses a threat to the traditional way of caring for
the elderly. There now appear to be diverse ways of doing family,
and there are varying strategies for coping with China’s changing
social and economic conditions. Processes and strategies for nego-
tiating and practising elderly care among adult siblings are shaped
and ­constrained by a range of factors, including where they work,
 SUMMARY AND IMPLICATIONS 183

the quality of relationships with their siblings and parents, and

between husband and wife, and their financial situations. Conflicts
are common, and are often entangled with bad feelings about past
events and situations. Although such ill feelings are often man-
aged by adult children, who still perform their care responsibili-
ties in order to conform to the social norm, the care is often
performed without love or positive feelings about duties to their
parents or parents-in-law.
Filial roles are still gendered in Dougou, although there have
been changes in the roles for sons, daughters and daughters-in-law.
In many cases, daughters are actively involved in negotiating their
parents’ care with their brothers. They play an increasingly impor-
tant role in providing all kinds of support to elderly parents in
Dougou, which echoes the findings of other studies (including Luo
& Zhan, 2012; Xu, 2001; Yan, 2002, 2003). It has also become
more acceptable for elderly parents in Dougou to stay for long peri-
ods in a daughter’s home; in the 1980s and 1990s, parents made
only short visits, especially if they needed physical care. However, no
parent of Dougou has yet died in a daughter’s home, at least not as
far as is publicly known. As illustrated by the story in Chap. 3, death
in a daughter’s home would damage a whole family’s reputation;
they would all lose face.
In Dougou, women’s increased status within the family and
growing contributions to family income, often through migrant
work, mean that they are empowered to provide more care for their
own parents, and at the same time have the power to provide less
care for their parents-in-law, especially instrumental care, as found
by Shi (2009) and Xu (2001). In some cases, daughters-in-law pose
a threat to the care provided to their parents-in-law when their hus-
bands feel pressured to provide less support to their own parents in
order to please their wives.
Yan (2002) has pointed out that changing gendered practices of
filial piety are greatly influencing rural villagers’ attitudes towards
daughters. In Yan’s (2002) study in Xiajia village in northern China,
some villagers were even satisfied with having a single daughter. Yan
interprets the new fertility culture (lower fertility rate and changing
attitudes towards daughters) as the result of the increasing role that
daughters play in elderly care, and the rising costs of raising ­children,
especially the ever-rising marriage-related expenses for sons. In
184 F. CAO

Dougou, for the same reasons, villagers’ attitudes towards daughters

have also changed since the collective period. Many couples stated
that nowadays people must have at least one daughter, and the ideal
situation is to have two children, one son and one daughter.

9.2   Policy Implications and Future Research

The policy implications suggested by these findings are that more resources
should be provided not only to the elderly villagers, but also to the rural
population in general, in order to ensure better elderly care, because the
main obstacle to good elderly care is not the decline of filial piety but the lack
of resources for everyone in rural areas. In Dougou in 2014, only five elderly
people were receiving retirement pensions. All the others had only minimal
pensions, inadequate to maintain even a minimum standard of living.
Currently, news programmes of both China Central Television (CCTV)
and provincial television channels frequently call upon people to respect
and care for their parents and parents-in-law. Advertisements for house-
hold products often contain a message about caring for parents and
parents-­in-law by giving them gifts. According to Wang (2004, p. 24), the
state ‘has reinforced, through official media, the renewed individual civil
(and family) obligation to take care of elderly parents, and promoted the
“socialist family virtues” of respecting, supporting, and caring for the
elderly’. However, the state’s intentional efforts to promote the traditional
virtue of filial piety through media will have only a minimum effect if no
additional support is provided for rural elders and the rural population in
general. As Miller (2004) notes, the Chinese government’s strategy of
relying on the family for old-age support in rural China is problematic. As
elders can contribute little to the family’s income, they have little power
within the family. They are thus reduced to having few bargaining chips
with which to demand elderly care from their sons and daughters-in-law.
As Ikels (2004, p. 4) says, ‘Tradition alone is seldom sufficient to motivate
people to behave in certain ways’. In order to gain better care from the
family, elderly people in rural areas need to be empowered by social sup-
port such as a minimum pension and affordable medical services.
As pointed out in Chap. 1, the percentage of people older than 60 years
in China has increased from 8.6 per cent of the total population in 1990
to 13.3 per cent in 2010 (Liu, Han, Xiao, Li, & Feldman, 2015, p. 124),
and the United Nations has estimated that by 2050, China will have
 SUMMARY AND IMPLICATIONS 185

become the largest ageing society in the world (UNDESA, 2011, cited in
Zhang, Guo, & Zheng, 2012, p. 590). Unlike most Western countries
which have established quite comprehensive formal care service systems,
China, especially in its rural areas, currently seriously lacks state-subsidised
elderly care infrastructure and services.
Eventually, China will have to implement community-based elderly care
services and expand residential (nursing homes) services in order to cope
with the rapidly ageing population and the needs of the rural families.
Migrant work has essentialised the problem of elderly care in rural China.
The narratives of participants in this study underline the need for these
services. Rural elders have been the casualties of state policies in national
economic development since Mao’s period. The Chinese state needs to
consider its role in supporting elderly people in rural China and the rural
population as a whole. State-driven elderly care programmes must be devel-
oped at both national and provincial level. They could be provided through
a mix of public sector, private sector and NGO contributions.
Currently, there is little community support for rural elders. But com-
munity services such as providing entertainment activities and laundry and
shower facilities would greatly benefit rural elders’ mental and physical
well-being. More general support for rural populations would also benefit
elderly people in indirect but significant ways. As Xiang (2007) argues,
compared with urban areas, rural populations have been left behind by
China’s political-socio-economic changes. Other kinds of support in rural
areas such as an increase in high-quality education, support for young
couples to establish homes and families, and public services such as waste
services would all benefit rural elders eventually.
For future research, I suggest that more studies could be conducted in
two areas. First, a study should be conducted to find out how migrant
work has affected intergenerational exchanges between younger rural peo-
ple (in their 20s) and their parents, and the changes in younger people’s
attitudes to care for their parents in the future. My research found that a
few young men in Dougou met their future wives in the places where they
work, in which case their parents pay less of the marriage-related expenses
than is the standard practice in Dougou. Further research among younger
people would reveal changes in parental obligations and possibly also in
intergenerational exchange patterns and their potential effects on care for
the elderly in rural China. In my research, I talked to fewer villagers below
the age of 30 than those in older age cohorts, and both key informants
were over 55 years old, who, in turn, usually referred me to middle-aged
and elderly villagers whom they knew.
186 F. CAO

Second, another study could look into the ‘Chinese way’ of developing
national policy and service programmes for both residential and community-­
based aged care in rural China. As Xu and Chow (2011, pp. 374–375)
point out, China is facing significant difficulties in establishing an elderly
care service model that incorporates China’s socio-political-­economic char-
acteristics and can satisfy the needs of its diverse urban and rural communi-
ties. The social, political, economic and cultural contexts of Chinese society
and Western societies are very different, and it is important that future
elderly care services and policies are tailored to the Chinese context.

Bibliography
Barbalet, J. (2016). Chinese individualisation, revisited. Journal of Sociology, 52(1),
9–23. https://doi.org/10.1177/1440783315587413
Chen, F. (2004). The division of labour between generations of women in rural
China. Social Science Research, 33(4), 557–580. https://doi.org/10.1016/
j.ssresearch.2003.09.005
Cohen, M. L. (1992). Family management and family division in contemporary
rural China. China Quarterly, 130, 357–377. https://doi.org/10.1017/
S0305741000040777
Georgas, J., Berry, J. W., & Kagitçibasi, Ç. (2006). Synthesis: How similar and
how different are families across cultures? In J. Georgas, J. W. Berry, F. J. Van
de Vijver, Ç. Kagitçibasi, & Y. H. Poortinga (Eds.), Families across cultures: A
30-nation psychological study (pp. 186–240). Cambridge, UK: Cambridge
University Press.
Ikels, C. (2004). Introduction. In C. Ikels (Ed.), Filial piety: Practice and discourse
in contemporary East Asia (pp. 1–15). Cambridge, UK: Stanford University
Press.
Kagitçibasi, Ç. (2006). Theoretical perspectives on family change. In J. Georgas,
J. W. Berry, F. J. Van de Vijver, Ç. Kagitçibasi, & Y. H. Poortinga (Eds.),
Families across cultures: A 30-nation psychological study (pp. 72–89). Cambridge,
UK: Cambridge University Press.
Landolt, P., & Da, W. (2005). The spatially ruptured practices of migrant
families: A comparison of immigrants from El Salvador and the People’s
Republic of China. Current Sociology, 53(4), 625–653. https://doi.org/
10.1177/0011392105052719
Li, L. W., Long, Y., Essex, E. L., Sui, Y., & Gao, L. (2012). Elderly Chinese and
their family caregivers’ perceptions of good care: A qualitative study in
Shandong, China. Journal of Gerontological Social Work, 55(7), 609–625.
https://doi.org/10.1080/01634372.2012.703165
Liu, H., Han, X., Xiao, Q., Li, S., & Feldman, M. W. (2015). Family structure and
quality of life of elders in rural China: The role of the new rural social pension.
 SUMMARY AND IMPLICATIONS 187

Journal of Aging & Social Policy, (03), 123–138. https://doi.org/10.1080/0

8959420.2014.977662
Luo, B., & Zhan, H. (2012). Filial piety and functional support: Understanding
intergenerational solidarity among families with migrated children in rural
China. Ageing International, 37(1), 69–92. https://doi.org/10.1007/
s12126-011-9132-1
Miller, E. T. (2004). Filial daughters, filial sons: Comparisons from rural North
China. In C. Ikels (Ed.), Filial piety: Practice and discourse in contemporary East
Asia (pp. 34–52). Stanford, CA: Stanford University Press.
Qi, X. (2016). Family bond and family obligation: Continuity and transfor-
mation. Journal of Sociology, 52(1), 39–52. https://doi.org/10.1177/
1440783315587796
Shi, L. (2009). ‘Little quilted vests to warm parents’ hearts’: Redefining the gen-
dered practice of filial piety in rural north-eastern China. The China Quarterly,
198, 348–363. https://doi.org/10.1017/S0305741009000344
Siu, H. F. (1993). Reconstituting dowry and brideprice in South China. In
D. Davis & S. Harrell (Eds.), Chinese families in the post-Mao era (pp. 165–188).
Berkeley, CA: University of California Press.
Smart, C. (2007). Personal life: New directions in sociological thinking. Cambridge,
UK: Polity.
Smart, C., & Shipman, B. (2004). Visions in monochrome: Families, marriage and
the individualisation thesis. The British Journal of Sociology, 55(4), 491–509.
https://doi.org/10.1111/j.1468-4446.2004.00034.x
Thøgersen, S., & Ni, A. (2008). ‘He is he, and I am I’: Individual and collective
among China’s rural elderly. European Journal of East Asian Studies, 7(1),
11–37. https://doi.org/10.1163/156805808X333901
United Nations Department of Economic and Social Affairs (UNDESA). (2011).
World population prospects: The 2010 revision. New York: United Nations.
Wang, D. (2004). Ritualistic coresidence and the weakening of filial practice in
rural China. In C. Ikels (Ed.), Filial piety: Practice and discourse in contempo-
rary East Asia (pp. 16–33). Stanford, CA: Stanford University Press.
Xiang, B. (2007). How far are the left-behind left behind? A preliminary study in
rural China. Population, Space and Place, 13(3), 179–191. https://doi.
org/10.1002/psp.437
Xu, Q., & Chow, J. C. (2011). Exploring the community-based service delivery
model: Elderly care in China. (Special issue: Older people). International Social
Work, 54(3), 374–387. https://doi.org/10.1177/0020872810396260
Xu, Y. (2001). Family support for old people in rural China. Social Policy & Admin-
istration, 35(3), 307–320. https://doi.org/10.1111/1467-9515.00235
Yan, Y. (2002). Planning birth: Changes in fertility culture in a Chinese village.
Etudes Rurales, 161–162, 129–152.
188 F. CAO

Yan, Y. (2003). Private life under socialism: Love, intimacy, and family change in a
Chinese village, 1949–1999. Stanford, CA: Stanford University Press.
Yang, H., & Chandler, D. (1992). Intergenerational relations: Grievances of the
elderly in rural China. Journal of Comparative Family Studies, 431–453.
Retrieved from http://www.jstor.org/stable/41602237
Zhan, H. J., Feng, X., & Luo, B. (2008). Placing elderly parents in institutions in
urban China: A reinterpretation of filial piety. (Report). Research on Aging,
30(5), 543–571. https://doi.org/10.1177/0164027508319471
Zhang, H. (2004). ‘Living alone’ and the rural elderly: Strategy and agency in
post-Mao rural China. In C. Ikels (Ed.), Filial piety: Practice and discourse in
contemporary East Asia (pp. 63–87). Stanford, CA: Stanford University Press.
Zhang, N. J., Guo, M., & Zheng, X. (2012). China: Awakening giant developing
solutions to population aging. The Gerontologist, 52(5), 589–596. https://doi.
org/10.1093/geront/gns105