Relational Geographies of Community Care for Older People in Urban Beijing, China

Abstract

With the paradigm shift of the place of care for older people from institution to community since the 1990s, the concept of community has re-invigorated aging research. Based on a relational approach, this thesis develops a heuristic framework of two co-constitutive triads. One triad is to unpack how community care manifest in three interdependent processes of policymaking (macro), localization (meso), and experience (micro). The other triad is to unpack community as a three-dimensional concept (material, social, and symbolic) to bridge trans-scaled spaces and places together. Specifically, this thesis seeks to answer four interrelated research questions: 1) What is the trans-scaled relationality of community in care for older people in the health geography literature? 2) What is the role of community in shaping “macro” policies of care for supporting community-dwelling older people? 3) What is the role of community in “meso” embedding care resources and spaces into local communities? and 4) What is the role of community in shaping “micro” experiences of care at a community-embedded facility? The findings demonstrate not only the material, social, and symbolic meanings of community at each process but also the trans-scaled relationality of these meanings: 1) Materially, lived experience of a community care facility is shaped not only by that facility (micro) but also by the processes of embedding the facility into the community (meso) and defining spatial units for allocating facility resources (macro); 2) Socially, social interactions of older people within that facility (micro) are shaped by the negotiation between different stakeholders in site-locating and relation-building (meso) that also relates to the negotiation of the state, market, and the voluntary sector (macro) ; and 3) Symbolically, ideas about what community should be like may converge or diverge between older people's affective senses (micro), stakeholders' concerns on the operation (meso), and normative principles to policymakers and wider society (macro). The thesis joins the recent “relational turn” in health geography by conceptualizing trans-scaled relationality of spaces and places through community. The findings can also inform strategically placing community care in China, Canada, and other countries where new models of community care for older people are being developed.