Despite policy commitments to aging in place and deinstitutionalization, little research has examined older adults with intellectual disabilities who continue to age in long-stay institutions, particularly in East Asian and other non-Western contexts. Using Taiwan as an East Asian case, this study explores how place-specific care arrangements, unmet support needs, and welfare infrastructures shape pathways into institutional care and experiences of institutional aging. We conducted in-depth life-history interviews with 13 residents aged 56-74 in four long-stay institutions in Taiwan. Drawing on a care poverty framework, we analyzed how unmet personal, practical, and socio-emotional support needs are embedded in broader cultural and welfare contexts. Entry into institutions commonly followed the breakdown of unpaid family care alongside limited access to home- and community-based services and supported housing. Gendered pathways were evident: men often entered after the death of a mother or other natal caregiver, whereas women more often entered after widowhood, following marriages to older military veterans or other socially disadvantaged partners. In five cases, a mother and her adult child with intellectual disabilities lived in the same institution, pointing to intergenerational institutionalization. Participants described institutional life as providing basic personal care while also involving isolation and limited control over daily life, relationships, and living arrangements. We propose poverty in choice and control to capture structurally constrained autonomy over where and with whom to live. The findings show how institutional settings reproduce lifelong disadvantage and offer broader insight into aging, care, and institutionalization in East Asia.

BACKGROUND:Health care accessibility and inequality for people with intellectual disabilities have long been subjects of discussion. Issues related to eye examinations and visits to ophthalmologists are particularly challenging for these people. However, disability studies and healthcare from the perspectives of people with intellectual disabilities remain scarce. The current study aims to explore the experiences and expectations of adults with intellectual disabilities during ophthalmologist visits, with a focus on their subjective viewpoints. METHODS:A qualitative study was conducted between 2021 and 2022 that involved semistructured interviews with 22 adults with intellectual disabilities who were users of day programs or residential services in Taiwan. The interviews, supplemented with pictures, were conducted using purposive sampling. Thematic analysis was used to analyse the data. FINDINGS:Four themes emerged regarding their experiences with ophthalmologists: 'Because my eyes itched, I went to the doctor;' the need for clear and slow explanations during vision screening; anxiety and discomfort during equipment use and focused examination; and 'The doctor is good. She smiles and is gentle with me.' In addition, two themes related to their expectations were identified:equipment use and pre-examination instructions and ideal characteristics of ophthalmologists: smiling and talking slowly. CONCLUSION:For people with intellectual disabilities, an ideal ophthalmologist is patient-centred and provides individualised care-'Smiling and Talking Slowly'; otherwise, fear of visiting eye doctors worsens their health inequalities. Integrating these considerations into ophthalmology training and practice is essential to enhance the quality of care for and the well-being and dignity of people with intellectual disabilities.

Geographers have connected the experiences of disabled persons with specific socio-spatial-political phenomena such as disability policies and laws, economic conditions, disability movements, and welfare systems. However, debates over disability theories and accessibility rights have lacked empirical data representing the perspectives of disabled people in Asia. In this study, the first to explore experiences with accessibility in an inter-Asian context, the daily experiences of disabled people in two Southeast Asian countries (Thailand and Vietnam) and two Northeast Asian countries (Japan and Taiwan) were compared. In each country, 10 wheelchair- or crutch-using residents of a large city were invited to be interviewed, of whom 39 participated. Results showed that disabled people's daily experiences are influenced by the cultural and historical contexts in which the concept of disability has been constructed. Attitudinal and cultural barriers to accessibility should be further examined, and Asian contexts should be included in the political geography of disability.

Since 2012, Taiwanese citizens with disabilities have been entitled to personal assistance from local authorities. To explore current features of personal assistance and barriers to its implementation, and distinguish it from homecare services, 33 disabled people and 12 staff members representing 10 local authorities in Taiwan were interviewed. Findings indicate that disabled people prefer personal assistance to homecare and perceive that relationships with their families have improved since the availability of personal assistance. However, many users' needs are unmet due to insufficient hours of service and costly co-payments. Results also show that development of personal assistance has been hindered not only by limited resource allocations but also by a lack of awareness of the concepts of independent living and personal assistance among staff. In the context of East Asian culture, independent living is misinterpreted as self-reliance, leading to the resurrection of the medical model of disability.Points of interestIn Taiwan, personal assistance was launched by a pilot program (2008-2010) run by a disabled people's organization.Since 2012, Taiwanese disabled people have been entitled to receive personal assistance from their local authority, but personal assistance has not been widely recognised by local authorities as an option to support disabled people's independent living.As in Western societies, Taiwanese disabled people prefer personal assistance to homecare. Personal assistance has also promoted positive relationships within families.Limited resources and local authorities' lack of understanding the meaning of independent living and personal assistance are the main barriers to the provision of adequate support.In the East Asian context, independent living has been misunderstood as self-reliance, suggesting no need for assistance or support, which has led to the domination of the medical model and of professionals' and carers' perspectives in the implementation of personal assistance.

This study contributes to the under-researched area of culture in institutional care for people with intellectual disabilities in an East Asian context. Drawing upon in-depth interviews with 20 women frontline care workers for institutionalized people with intellectual disabilities in Taiwan, we examined culture-specific caring relations such as the fictive kinships of Confucian care ethics (i.e., respect for elders and affection for the young), the charity paradigm, and religious compassion, which can induce attentive and respectful care in institutional spaces but also relegate residents to stigmatized subordination in a hierarchy of caring relations and legitimatize the voluntary exploitation of women workers. In situating the relational nature of care and the dis-enabling potentials of culture at the disability-care-place intersection, we promote an ethics of engagement that values and dignifies both recipients and providers of care.

This paper sets out a theoretical agenda for Cultural Landscapes of Care. It highlights the importance of engaging the cultural vectors within different 'care-ful geographies', in order to highlight the role of culture as both a lens of knowing a meaningful way of life, and a critical hermeneutic. Through revisiting discussions around everyday practices of care, both in this journal and elsewhere, we outline a research agenda that re-engages culture with inquiries into the relations between place and care, including spatialities of care, ethics and justice. We call for a shift to thinking with culture and its moral dimensions in order to make sense of the tensions, ambiguities and boundaries of care marked by austerity, neoliberalism and globalisation. We therefore coin the term 'cultural landscapes of care' to advance an agenda that is contextually and culturally sensitive, and committed to understanding what good care means in diverse trans-local contexts. Gathering together the papers in this collection, we show how culture 'filters' through meaningful everyday care practices. We argue for an understanding of culture as a toolkit and a condition for ethical encounters of care. Thus, we translate situated examples of caring experiences into a global standpoint of care-ful geography.

Young people with intellectual disability (ID) rarely have opportunities to form intimate relationships or receive long-term interventions promoting their sexual health and awareness of sexual rights. To promote sexual health in adults with ID in Taiwan, we utilized intervention research and inclusive research to introduce three interventions that involved adults with ID, their parents, and service workers. This paper primarily evaluates the outcomes of a two-year intervention to promote sexual and reproductive health knowledge/positive attitudes and quality of life for adults with ID. A non-equivalent multiple-groups with replications design was used to gather data from 87 adults with ID. In-depth interviews and focus groups were used to collect the experiences and perspectives of adults with ID, service workers and parents. Although the experimental groups did not show a strong quantitative increase in sexual knowledge and sexual attitudes, the qualitative data indicated that the dialogues with and among the participants transformed their perceptions of sexual needs from being sexual problems to being sexual rights, which was empowering for adults with ID. Involving parents and service workers in the intervention and facilitating dialogue between these groups are essential to transform sexual problems of adults with ID into sexual rights.

This paper explores the relatively unexamined topic of interactions between corporeal and affective dimensions in male sexual labour, focusing on the role of intimacy in the bodywork of erotic gay massage in Taiwan. Feminist perspectives on bodywork and affective embodiment are used to analyse how intimacy is lived out during commodified same‐sex engagements. Drawing upon in‐depth interviews with 34 self‐identified gay masseurs, I examine two prominent servicing features of male‐for‐male massage: crafted intimacy and unscripted care. Whereas the former refers to the ‘boyfriend experience’ built up through tactile encounters, the latter regards erotic services as caring practices for the socially vulnerable, adding a moral dimension to the cultural significance of gay sexual commerce in Taiwan. This paper concludes that corporeal and affective dimensions are inseparable in understanding gay massage. Further research can benefit from more attention to somatic affection in the interplay between bodywork and intimacy in male sexual labour.

This work studies the interdiffusion effect of Er ions in Er2O3 and Si ions in SiO2 on the photoluminescent (PL) properties of Er2O3/SiO2 films. Er2O3 layers are deposited on thermally oxidized Si substrates by reactive radio-frequency magnetron sputtering. Different interdiffusion behaviors are observed by thermally treating films with rapid thermal annealing (RTA) and tube furnace annealing (TFA) at 900–1200°C. Surface morphological and compositional properties are measured by optical microscopy, atomic force microscopy, and secondary ion mass spectroscopy. Surface roughness of composite films increases with the annealing temperature due to growth in grain size. The Er/Si interdiffusion across the Er2O3/SiO2 interface is observed when the annealing temperature exceeds 1000°C for RTA and 900°C for TFA. Thermal annealing effects in the oxygen ambient include the Er doping in the SiO2 layer, the formation of erbium silica, and the reduction of defect density. These three factors facilitate the increase of active Er ions and the enhancement of PL intensity. The PL intensity increases with the Er/Si interdiffusion thickness for RTA- and TFA-treated films. Enhancement of PL intensity with the annealing temperature is attributed to the Er/Si interdiffusion and the reduction of defect density.

This article maps out gendered practices among Taiwanese (younger) professional men, examining how they make sense of their gendered identities through local traditions and cultural practices, such as kin values and filial responsibilities. Although existing literature suggests that late modernity is marked by a decline in tradition, such claims are often under-theorised, with little connection to lived experience. Drawing on qualitative research undertaken in Taiwan, this article explores how the tension between tradition and detraditionalisation is culturally lived out by elder and younger generations. Specifically, it argues that traditions do not disappear but rather become a complex resource in making sense of the men's gendered identities. By situating gendered reflexivity within the tension between tradition and detraditionalisation, the article brings together some of the theoretical and cultural complexities involved in understanding contemporary gender relations in Taiwan at a time of rapid global change.