The Other Side of Filial Piety: Negative Impacts on Caregiver of Parents Living With Dementia

Introduction: Filial piety is a deeply rooted moral principle in Chinese culture that guides the parent-child interaction and defines the obligation to care and respect for parents and elderly in East Asian societies. Extended research provides evidence to its merits on reducing caregiving burden and stress, as well as enhancing positive aspects of caregiving. However, little focus has been put on its negative aspect, especially on dementia caregiving process. Objectives: This study aims to explore how filial piety negatively affects the caregivers during the caregiving process for parents living with dementia. Methods: Semi-structured interviews with 18 Hong Kong children caregivers of persons with dementia recently admitted to a residential care facility (i.e. less than one year) were conducted in fall 2014-2015. Interviews covered respondents’ retrospective evaluation of their caregiving experience and long-term care decision, were tape recorded and transcribed verbatim for thematic analysis. Results: Four aspects of filial piety including obligation, respect, hierarchy, and attachment were identified in relation to the negative impact on caregiver with dementia parents. Under these four aspects, ten themes were further classified: conflict of responsibility allocation, the sacrifice of original life, caregiver burden, disagreement in collective decision making, struggle in shifting responsibility, handling social stigma, delay intervention, subordinate position in a caregiving relationship, and loss of emotional attachment. Conclusion: Taking care of parents with dementia is challenging. Besides regular caregiving duty, carers need to handle extra regulation and expectation from the belief of filial piety. This deeply rooted moral principle not only creates an internal burden for the carers but also puts them under external social pressure. Therefore, it is suggested that caregiving support on dementia should not solely focus on people with dementia. Extra resources and appropriate interventions which address the children carers’ needs will be beneficial to these caregiving dyads. Disclosure of Interest: None Declare