Navigating Interdependence: The End-of-Life Caregiving Process of Adult Only Children Caring for Their Parent

The one-child policy has shaped the life trajectories of millions of only children in China. As this cohort ages into mid-life, providing end-of-life care to their aging parents is becoming a critical social issue. Their lived experiences and sociopolitical context likely lead to distinctive end-of-life caregiving experiences; however, to date no existing literature has investigated this phenomenon. This study uses a convenience sample of 15 adult only children who provided at least one month of end-of-life care leading up to their parents' death to explore their caregiving process. This study uses thematic analysis to present findings. The emergent caregiving process encompasses four phases of interdependence depicted through the metaphor of charting a sailing voyage: (1) Sailing Out of the Harbor: Continued Interdependence and Life Routes; (2) Navigating Back to the Harbor: Inverted Interdependence and Shifting Life Emphasis; (3) The Collapsing Harbor: Decoupling Interdependence and Preparation for Bereavement; and (4) The Navigator's and Harbor's Reconstruction: The Divergent Interdependence and Social Life. Three turning points sequentially connect the four phases: (1) realizing the severity of the illness and shifting to prioritize caregiving; (2) sensing the impending death; and (3) death of and farewell to the parent(s). The parent-child relationship anchors the process, while sociocultural context and illness progression drive the process forward. Practitioners can provide competent psychosocial care in response to the unique dynamics of interdependence and caregiving stress in individual cases. Advocacy for death education and policies that promote hospice and palliative care are recommended.