Who Causes the Most Challenges in Aged Care? A Data-Driven Look Through an Asian Lens

When people think about aged care challenges, the mind often goes to the residents, the staff, or the families. But the truth is more layered—especially in Asia, where cultural values like filial piety (the duty of children to care for parents) still hold strong influence.

In Malaysia, Singapore, and across Asia, families often face guilt when placing parents in a care centre. Staff, already stretched thin, must balance cultural expectations with clinical realities. And residents, caught in between, are adjusting not only to care routines but also to the cultural perception of “being sent away.”

So, who really causes the most challenges—staff, residents, or families? The answer is less about blame and more about the intersections where these groups meet.

Staff: The Beating Heart, But Overstretched

In every care home, nurses and caregivers are the backbone. They provide meals, medication, hygiene assistance, and companionship. In Asia, many frontline staff are migrant workers—from Indonesia, the Philippines, Myanmar, or Nepal—who face additional pressures like language barriers and cultural gaps with residents and families.

Burnout is real. Studies across the region show that over 30% of care staff struggle with work–family conflict, and in countries like Malaysia, high turnover makes the situation worse. Long shifts, emotional fatigue, and the cultural expectation that “staff must serve with heart” create heavy burdens.

This is where clashes begin: an exhausted caregiver facing the high expectations of a family steeped in Asian respect-for-elders traditions.

Residents: Living with Change, Living with Tradition

Residents are rarely “difficult” for the sake of it. Instead, their needs—whether medical, emotional, or social—reveal the stress points in the system.

In Asia, the emotional transition is often sharper. Many older adults feel a sense of shame being in an aged care centre, as society still prizes multigenerational households. Some residents may worry about “burdening” children, while others struggle with loneliness when visits are infrequent.

For residents with dementia, challenges include resisting care, confusion, or even aggression. These behaviours are not just medical—they are cultural too. An elder who once commanded authority in the family hierarchy may now feel powerless, sparking frustration that caregivers must navigate carefully.

Families: Partners in Care… and Carriers of Guilt

Family members in Asia often bring deep cultural expectations into the aged care equation. A son or daughter may feel guilt for “sending mum away,” while still demanding high standards from the facility.

Conflicts are common. In fact, research shows that nearly half of families experience disputes—often among siblings—about how care should be managed. In Asia, this is heightened by filial duty and by who carries the caregiving role (often the eldest son’s family, or the unmarried daughter).

Even after admission, many Asian families remain heavily involved—visiting daily, bringing home-cooked meals, or checking in with staff frequently. This involvement is valuable, but it can also lead to tension if families feel sidelined or if staff feel micromanaged.

The Real Challenges Live at the Intersections

So, who causes the most challenges in aged care? Staff, residents, or families? The truth is, it’s none of them alone.

The hardest moments emerge where expectations, culture, and capacity collide:

• A caregiver balancing ten residents while a daughter insists her father deserves personal attention.

• A resident with dementia refusing care, while siblings argue about the “right” traditional or medical approach.

• A family anxious about whether filial piety is being “fulfilled,” while staff focus on clinical routines.

These aren’t battles of good vs bad—they’re clashes of culture, care, and circumstance.

What Can Help? From Conflict to Collaboration

Asian aged care is unique, but solutions are universal:

1. Structured Communication
   Regular updates, WhatsApp groups, and family meetings can align expectations. When families feel heard, tension decreases.

2. Cultural Sensitivity in Training
   Staff—especially migrant workers—benefit from understanding Asian traditions, food preferences, religious practices, and the weight of filial expectations.

3. Family as Care Partners
   Instead of seeing families as “too demanding,” centres can frame them as allies. Inviting them into activities, meal planning, or festivals makes them feel valued.

4. Emotional Support for Staff and Families
   In Asia, open discussion about grief and guilt is rare. Safe spaces—whether peer groups, counselling, or even community talks—can help everyone process emotions.

Final Word

The biggest challenges in aged care don’t come from staff, residents, or families alone. They come from the cultural, emotional, and systemic pressures that bind them together.

In Asia, where filial piety and tradition meet modern realities, these challenges are even more pronounced. But they can also be opportunities—opportunities to build stronger, more collaborative relationships that put the resident at the centre.

After all, aged care isn’t about pointing fingers. It’s about remembering why we are all here: to ensure our seniors live with dignity, respect, and love.