EXPLORING PAIWAN ELDER VIEWS OF HEALTH, AGING, AND SERVICE PREFERENCES
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2024
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Abstract
The objective of this dissertation was to develop a cultural lens for the Paiwan tribe of Taiwan by exploring Indigenous definitions of health and healthy aging and preferences for eldercare. My interest in this topic stems from my membership in the Paiwan community and as a former employee and current volunteer with our local tribal elderly care center. I completed three studies for this dissertation.In Study 1, I explored definitions of elderhood among Indigenous Peoples through a systematic literature review. To do this, I reviewed studies in which elderhood was defined and perceived within Indigenous communities. I found that the definition of elders within Indigenous communities predominantly revolves around their portrayal as symbols of wisdom, custodians and transmitters of cultural knowledge, and their ability to guide the sustainable development of tribes. Within Indigenous communities, elders are not only witnesses to history but also guardians of cultural values and traditional knowledge. This perspective of elderhood is critical for understanding healthy aging in Indigenous communities.
In study 2, I established a “conceptualization of healthy aging” among Indigenous Paiwan elders. To do this, I conducted a focus group with Indigenous elders on their perspectives and thoughts regarding Paiwan health and healthy aging. I found that healthy aging encompasses more than just physical well-being. It includes the following aspects: establishing connections and interactions with others, communities, and traditional cultures; engaging in lifelong learning; contributing to one's tribe and family; and generating additional value in traditional domains. Furthermore, this study discovered that among the Paiwan elders, the definition of elderhood is not solely based on chronological age but rather on personal achievements and contributions to the tribe. This definition differs from that of elderhood in mainstream Taiwanese society. Additionally, the establishment of cultural health stations was found in this study to be beneficial for elder health. However, elders wanted the stations to increase land-based activities and substantively involve the tribe in the operation of stations. In Study 3, I identified the reasons that Paiwan elders participate and do not participate in the currently operating day care stations established by the Taiwan government. To do this, I administered a quantitative survey with the elders in daycare stations and elders not in the daycare stations to assess their reasons for participating or not and how services can be improved. I found that the elders, whether were or not they participated in the daycare stations, agreed that the current daycare stations were supportive and beneficial to their later lives. However, gender, age, living with others, personal economic status, and acceptance of the activities currently offered at the stations influenced their participation of daycare stations.
The findings from this dissertation will assist Indigenous Paiwan elders to improve the structure and cultural relevance of services and policy around long-term care for their communities.
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Aging, Public health, Cultural Daycare Center, Elderhood, Healthy Aging, Indigenous Health, Paiwan
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119 pages
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