Navigating Interdependence: The End-of-Life Caregiving Process of Adult Only Children Caring for Their Parent

TL;DR

This study explores the unique end-of-life caregiving experiences of adult only children in China, shaped by the one-child policy and cultural context.

Contribution

It is the first study to investigate the end-of-life caregiving process of adult only children in China.

Findings

The caregiving process is characterized by four phases of interdependence, metaphorically described as a sailing voyage.

Three turning points mark the progression of the caregiving journey, driven by illness severity, impending death, and parental death.

The parent-child relationship and sociocultural context are central to understanding caregiving dynamics and stress.

Abstract

The one-child policy has shaped the life experiences of millions of only children in China and providing end-of-life care to their aging parents is becoming a critical social issue. Their unique lived experiences likely lead to distinctive end-of-life caregiving experiences, however, to date no existing literature has investigated this phenomenon. This study uses a convenience sample of 15 adult only children who provided at least one month of end-of-life care leading up to their parents’ death to explore their end-of-life caregiving process. Adopting a social constructionist paradigm, this study uses the “In-Vivo” approach to theory-building and thematic analysis to visualize and present findings. The emergent caregiving process encompasses four phases of interdependence depicted through the metaphor of charting a sailing voyage: 1) Sailing Out of the Harbor: Continued Interdependence; 2) Navigating Back to the Harbor: Inverted Interdependence and Shifting Life Emphasis; 3) The Collapsing Harbor: Decoupling Interdependence and Preparation for Bereaved Life; 4) The Navigator’s and Harbor’s Reconstruction: Divergent Interdependence and Social Life. Three turning points sequentially connect the four phases: 1) realizing the severity of the illness and caregiving should be the main task; 2) sensing the possible coming death; 3) death of or farewell to the parents. The parent-child relationship anchors the process, while sociocultural context and illness progression drive the process forward. Practitioners can provide competent psychosocial care in response to the unique dynamics of interdependence and caregiving stress in individual cases. Advocacy for death education and policy to promote hospice and palliative care are recommended.