Universität zu Köln

Shi, Ziyuan ORCID: 0000-0003-1829-752X (2026). Forging Care: An Ethnography of China's Institutional Eldercare and its Uncertainties. PhD thesis, Universität zu Köln.

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Abstract

Over the past three decades, rapid population aging in China has been met with an equally rapid institutionalization of eldercare. I diagnose the political configuration driving this expansion as welfare paternalism: a mode of rule through which the party-state claims to act in its subjects’ best interests, mobilizing expertise, policy, and public funding to professionalize and standardize nursing homes in the name of “people’s well-being,” and staging seniors as emblematic recipients of its benevolence. Yet for many elders, these changes are experienced not as care but as a pervasive uncertainty. Based on fourteen months of fieldwork at Sunset, a flagship commercial nursing home of roughly 400 residents in eastern Zhejiang, and at an affiliated sub-district civil affairs office, this ethnography asks how people forge meaningful relations of giving and receiving care amid the tension between institutionalization and the contingencies of living with, and as, elders. I argue that welfare paternalism, colliding with state-capitalist privatization and post-reform moral transformation, generates a moral-welfare upheaval in which the value of late-life dependency, the boundaries of responsibility, and the meaning of provision are all contested—above all between elders and their significant others. To cope with such uncertainties, actors engage in what I call ethical labour: the communicative and interpretive work of speculating others’ intentions and mobilizing polysemic values such as thrift, guan (care/control), and zhaogu (accommodation) to render ambiguous arrangements intersubjectively recognizable as care, however provisionally. This labour is rarely egalitarian, often relying on coaxing, control, and deception, yet it reveals the depth of moral investment rather than individual failing. Building on these findings, I propose that care is most productively understood as a fragile social realization. By decentering filial piety and recentering elders’ own moral agency, the thesis contributes to the anthropology of China and to a broader anthropology of care, foregrounding ethical labour as an underrecognized form of labour in human interdependence.

Item Type:	Thesis (PhD thesis)
Creators:	Creators Email ORCID ORCID Put Code Shi, Ziyuan shizy1996@gmail.com https://orcid.org/0000-0003-1829-752X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-806624
Date:	2026
Language:	English
Faculty:	Faculty of Arts and Humanities
Divisions:	Faculty of Arts and Humanities > Fächergruppe 4: Außereuropäische Sprachen, Kulturen und Gesellschaften > Institut für Ethnologie
Subjects:	Social sciences Other languages
Uncontrolled Keywords:	Keywords Language institutional eldercare; welfare paternalism; moral frictino; ethical labour; filial piety; elderhood; China English
Date of oral exam:	13 July 2026
Referee:	Name Academic Title Brandtstädter, Susanne Prof. Dr.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80662