Family at the Bedside: Strength of the Chinese Family or Weakness of Hospital Care?

Abstract

Using qualitative and quantitative data collected from 70 patients in three hospitals in Taiwan, between 1990 and 1991, this article documents the pervasive and intensive involvement of patients' families in hospital care. Two hypotheses are examined: (1) that family involvement is a result of the strength of Chinese family ties; and (2) that the involvement is necessary due to inadequate hospital care. The results suggest that intensive and extensive family involvement in inpatient care is an involuntary response to the short-comings of hospital health care in Taiwan. The ability of a patient to care for her- or himself is critical in determining when and how a family provides bedside care. Taiwanese families adopt a cost-minimizing approach in deciding who will be the primary caregiver. Hiring nurse-aides is an alternative when intensive care is necessary but no family member is available. The inadequacy of hospital care entails hidden social and economic costs to the family, most of which are not incorporated into conventional estimates of expenditure on hospital care.