2025 Theses Doctoral

Navigating Long-Distance Caregiving for Elderly Parents: Lived Experiences and Needs of Female Informal Caregivers from China's One-Child Generation

Dang, Zihan

China’s rapidly aging population, combined with the long-term consequences of the One-Child Policy (OCP), has significantly reshaped caregiving dynamics—particularly for married, only-child daughters. Traditionally, elder care was the responsibility of sons and daughters-in-law. Today, however, demographic shifts and evolving gender norms require many daughters to care for up to four elderly parents—their own and their in-laws—while simultaneously managing careers and raising children. These challenges are further amplified by international migration, as geographic separation complicates the fulfillment of filial piety norms rooted in physical proximity.

This study explored the caregiving perceptions, lived experiences, and unmet needs of female One-Child Generation caregivers residing in the United States, with a particular focus on the role of technology in supporting long-distance caregiving. Forty-seven married Chinese women, aged 30–45, were recruited through purposive and snowball sampling. All participants were raised with strong Chinese cultural values, were the sole children in their families, and had provided remote care to their aging parents for at least one year while living in the U.S.. Data were collected through sixty-minute semi-structured interviews and analyzed using thematic analysis with both deductive and inductive coding approaches.

Guided by Leininger’s Transcultural Nursing Theory, this study revealed a transformation in filial norms—from rigid, one-sided obligations to more reciprocal and negotiated caregiving relationships. Traditional gender roles are being redefined, prompting clearer boundaries as daughters balance responsibilities between their own parents and in-laws. Elders are also adjusting their expectations in response to these evolving norms. Religion and spirituality emerged as important cultural and emotional resources, providing caregivers with strength and resilience amid complex caregiving arrangements.

Integrating the Transactional Model of Stress and Coping, this study illustrated how interpersonal relationships, cultural pressures, and limited support networks shape the psychological landscape of transnational caregivers. Many caregivers experience a mix of guilt, anxiety, and love, compounded by uncertainty about future obligations and the challenges of managing care from afar. Informed by Sociotechnical Systems Theory, critical gaps in caregiver support were identified. While technology offers promising tools for addressing issues such as healthcare access, emergency coordination, and financial management, it often functions as a supplement—not a substitute—for in-person care. Emotional connection, peer support, and culturally attuned resources remain essential.

These findings call for a reimagining of caregiving models that reflect the realities of a globalized world. By introducing concepts like parallel caregiving, anticipatory caregiving, and inverted abuse, the study challenges traditional filial norms and highlights the emotional complexity of transnational care. It underscores the critical role of spirituality, emotional reciprocity, and personal autonomy in shaping caregiving dynamics. While technology supports logistical tasks, it cannot replace the emotional depth of in-person connections, social engagement, or the comfort of companion animals. Ultimately, this study advocates for culturally responsive, holistic, and cross-border support systems that empower caregivers and address the full spectrum of caregiving needs.