'Reframing Expectations'- A Contextual Approach to Understanding and Addressing Elder Abuse in Hong Kong: A Constructionist Inquiry

The phenomenon of elder abuse is of growing social concern worldwide and yet remains a relatively under-researched and under-theorised area. This is particularly the case in Hong Kong where elder abuse has only recently received any official recognition and is portrayed in a narrow and sensationalised way in public media. To compound matters Western concepts of elder abuse have been adopted and applied in a largely uncritical manner.

The study described in this thesis explored perceptions of elder abuse amongst community dwelling older people and health and social care professionals in Hong Kong. The aim was to develop a culturally relevant conception and knowledge of elder abuse to further understanding and to suggest new approaches to addressing elder abuse. Applying the principles of constructivist grounded theory in this study, data were collected using in-depth interviews, vignettes and focus groups. Analyses revealed that participants used a number of subtle and often implicit processes when deciding if a behaviour was abusive. This involved ‘evaluating’ the behaviour against a set of ‘expectations’ to determine if it was potentially abusive or not. If it was seen as potentially abusive then efforts were made to try and ‘explain/excuse’ the behaviour. If it could not be ‘excused’ then professionals usually ‘exposed’ the abuse whereas older people often chose to ‘endure’ the abuse to avoid a potential ‘loss of face’. These differences in perceptions of abuse, and responses to it, between older people and professionals were largely as a result of how older people adhered to traditional Chinese cultural values, especially filial piety.

Based on the results, a ‘contextual’ theory of elder abuse was developed. This suggested that if elder abuse is to be better understood then consideration has to be given to the interactions between six contexts: the individual; the relational; the community; the caregiving; the cultural and the societal. The thesis concludes with an overview of the actions that need to be taken in each of these contexts if new approaches to addressing elder abuse are to be developed.