Challenges of Paid Caregiving in China: Enhancing Integration through Social Network Theory

China’s aging population has increased reliance on migrant live-in paid caregivers, especially in urban areas like Shanghai. This study explores their experiences through Social Network Theory (SNT), focusing on cultural adaptation, psychological stress, and resource limitations within family, agency, and peer networks. A qualitative multiple case study was conducted using semi-structured interviews and participant observations across multiple Shanghai districts. Participants included paid caregivers (n=26), care recipients (n=22), family caregivers (n=22), and supervisors (n=4). Findings highlight the influence of upstream structural factors (e.g., filial piety, migration policies) and downstream relational factors (e.g., social support, family expectations). Caregivers face a dual burden of professional responsibilities and emotional labor, contributing to stress and job insecurity. Addressing these challenges requires policies that integrate cultural training, expand social support networks, and enhance institutional resources. This study provides theoretical insights into caregiving in China and practical recommendations to support this vulnerable workforce.