Constructing and deconstructing the self: dementia in China

Within the research and clinical communities in China senile dementia is recognized as either a progressive neurological disease that is associated with aging but is not an inevitable part of it or as a concomitant of vascular disease. These understandings are only partially shared by ordinary Chinese many of whom, on the contrary, view dementia as a natural aspect of aging. Nevertheless the elderly seem less fearful and family members less appalled by the prospect of dealing with dementia than is the case in countries like the United States. While high rates of intergenerational co-residence and other situational factors moderate the impact of dementia and facilitate the delivery of care to the demented, these facts alone are insufficient to account for these different responses. Rather four cultural concepts: (1) the heart/mind, (2) the nature of morality, (3) the nature of the self, and (4) filial piety taken together construct a distinctive experience of dementia in China that preserves the self far longer and rewards the care-giver more profoundly than is the case in the United States.