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Abstract

This thesis aims to examine the everyday experiences of Chinese people living with dementia using formal support services in Vancouver, Canada and uncover how broader institutional practices and embedded systemic oppression shape the experiences. Research to date documents that racialized individuals are less likely to use formal services but fails to examine how structural causes, such as racism, contribute to these disparities. Adopting critical theories on race and intersectionality, this study centres race and systemic racism while considering the intersection of dementia with other social locations in the analysis. Using institutional ethnography (IE) as its methodology, the study began by interviewing Chinese individuals living with dementia to obtain their standpoint and identify problematics, the tensions arising between their everyday lives and institutional operations. This was followed by analyzing relevant texts to reveal ruling relations and dominant discourses that mediate these experiences. A key analytical step involved linking interview and textual analysis to identify disjunctures where these ruling relations are visible. Key findings reveal that experiences are textually mediated by four interconnected themes: the dominance of the biomedical lens, which prioritizes physical aspects and professional knowledge over holistic care and lived experience; the impact of neoliberalism which frames independence as a personal responsibility and dependence as a societal burden; governmental policies expectation of families to provide care; and, the invisibility of the intersection of race with age and dementia in texts which contributes to structural racism. The significance of this study lies in its reframing of dementia care, situating Chinese lived experiences within broader structural forces. It reveals the dominance of the biomedical lens, acknowledges cultural importance while challenging cultural essentialism, and exposes structural racism. The findings underscore the need for more holistic and equitable care, with implications for practice, policy, theory, and future research.