机构养老的合法化:家庭与机构的协作

The Legitimation of Institutionalized Elderly Care:A Family-Institution Cooperation

通过实地调查,本文探讨了机构养老何以被人们所接受。研究发现,家庭与机构的协作促成了养老观念的改变,若仅靠一方努力,机构养老的合法化将难以实现:一方面,养老家庭亲子双方均持续为机构养老争取合法性,重建对养老机构的认知并应对外界的污名;另一方面,养老机构也在通过争取专业性、制度政策性和社会文化性认可来回应外部偏见。最终,在代际情感及功能交换被强化的同时,机构养老获得了承认。本文通过梳理家庭成员作为个体行动者与机构作为组织行动者的行动以及二者之间的关系,阐释了机构养老在孝道文化深厚的中国社会被接受的机理,弥补了养老观念研究对养老机构行为的忽视,打破了既有文献重家院对立、轻家院合作的局面,将对家庭与机构二元分野的弥合提升到了认知层面。

Through field observations,parent-children paired-interviews and the text analyses of service contracts and management norms in three elderly care institutions,this study investigates how institutional elderly care as a new form of elderly support has been accepted in China.The study finds that it is the cooperation between families and institutions that has led to a change in perceptions of aged-care,and that the legitimation of institutional elderly care would be difficult to achieve through the efforts of only one of the two parties.This cooperation arises out of the strong sociocultural resistance that both sides have to face in the transition from family care to market-based institutional care.On the one hand,parents and their adult children continue their effort to justify their choice of institutional care,and are compelled to accept the new cognition of institutional care while actively responding to external stigma.In this process,parents and children follow different logics of action,with the former focusing more on self-persuasion while the latter on responding to external prejudices.On the other hand,care facilities subvert negative stereotypes through the pursuit of professionalism,institutional policy,and socio-cultural recognition.While emotional and functional exchanges between generations have been strengthened,institutional elderly care has gradually gained acceptance in China.By sorting out the behaviors of the families as individual actors and the institutions as organizational actors,as well as examining the relationship between the two,this study explains the mechanism of acceptance of the emerging institutional elderly care in China,where the traditional filial piety culture is deeply rooted.The study compensates for the existing literature’s long-standing neglect of the behaviors of institutions and redresses its over-emphasis on the tension between the family and the institution but not on the cooperation between the two,and elevates the discussion beyond care towards the cognitive realm.