The importance of reciprocity in caring for older people with dementia: the experiences of female family carers in Thailand

This thesis explores the importance of reciprocity in caring for older people with dementia in Thailand, employing a feminist approach focusing on concepts of care, gender, reciprocity, family practice, and motivation. It draws on in-depth interviews (n19) which asked how female family carers make sense of repayment in caring, how they perceive the reciprocation given by their older relatives with dementia, and how their experiences of reciprocity relate to motivation to care. The study reveals the notion of repayment to remain consistent as a significant social norm in Thailand, regardless of the reasons for caring. The carers explained the notion in ethical terms, reflecting the concept of connectedness. Previous research has highlighted the social value of ‘katanyu’ in caring for older relatives in Thailand. In this study, participants undertook care not simply to follow this value, but negotiated it within their caring circumstances, where an ethics of care frames their actions. While reciprocity in dementia care is typically understood to be limited, this research reveals how carers were the subjects of reciprocation from those for whom they cared, implying the agency of people with dementia. Expressed in various forms, verbal and non-verbal, such reciprocation was interpreted by carers using a mix of intimate and cultural knowledge, embedded meanings being understood as both positive and negative. Significantly, carers perceived reciprocation through the lens of connectedness with care recipients. Overall, participants’ motives to care were derived from and negotiated through reciprocity occuring over the lifecourse of caring, but also based on Buddhism’s wider timeframes influenced by the belief in karma and the cycle of birth and rebirth. The study contributes to research knowledge in sociology, social psychology, cultural gerontology, and nursing, bearing policy and practice implications relating to family and dementia care in which aspects of caring, gender, and generational reciprocity intertwine.