Decisions for institutionalization among nursing home residents and their children in Shanghai

An increasing number of elders in Shanghai have moved into nursing homes to meet their needs for long-term care. This shift from family caregiving to nursing home care calls for an exploration of caregiving decision making in urban China. In this article I present both generations' experiences of deciding to institutionalize. Face-to-face, semistructured interviews took place with 12 dyads of matched elders and their children (N = 24) in a government-sponsored, municipal-level nursing home in Shanghai. Spatially situated in a Cartesian coordinate system, the essence of participants' experiences showed that they either proactively or reactively chose institutionalization. Proactive families were motivated to prevent potentially increasing caregiving burdens that might exceed family caregiving capacity, whereas reactive families sought institutionalization after they had depleted caregiving resources at home. The findings illuminate diverse needs for long-term care of Chinese elders-the world's largest aging population-in the coming decades.