Aging in Place with Few Children and Social Services-- Understanding Structural and Cultural Lags in Rural China.

This study uses mixed methodologies to reveal how structural and cultural changes are changing the connotations of home and aging in rural China. Based on surveys (n = 830) and 33 intensive interviews with older migrant workers, this study found that having rural public pensions, adult children living nearby, and owning land in their hometowns were associated with the respondents' desire for aging in place (AIP). Moreover, although the image of the rural home is idyllic, the reality is difficult. Aging migrant workers are gaining a strong sense of financial independence and their children's lack of parental care. The authors argue that having no social-care services, while adult children are rarely available for old-age care, is changing the connotations of AIP in rural China. These social and cultural transformations are making AIP more of a romantic ideal than a practical reality for migrant workers.

Finding a Sense of Home across the Pacific in Old Age- Chinese American Senior's Report of Life Satisfaction in a Foreign Land.

Finding a sense of home for international migrants is challenging. It is even more so for older adults who migrate to a foreign country later in life to follow their adult children. This study examines Chinese immigrant elders' report of their sense of home and life-satisfaction. Based on 21 intensive interviews and107 surveys with elderly immigrants of Chinese descent, this research finds that a comfortable living condition in a natural and built environment contribute to Chinese elders' narrative of a sense of home. The lack of English language, however, makes immigrant Chinese elders feel very unsettled. Being together with children and having good social benefits are major pull factors that contribute to immigrant elders' decision to settle down in a foreign country. Those who report a stronger sense of home tend to report a higher level of life satisfaction. In conclusion, the authors argue that immigrant elders are defining their sense of home with a greater sense of independence from their adult children. Favorable social policies toward older adults, such as Medicare, Medicaid, low income housing, and social services, are important factors that make older immigrants feel a sense of home in a foreign land, although the inability to communicate is a barrier to a complete sense of home for transnational migrants in old age.

The third-age African American seniors: benefits of participating in senior multipurpose facilities.

This article examines the contexts and benefits of African American seniors' participation in multipurpose facilities. Using qualitative data from 15 in-depth participant interviews and 6-month on-site participant observations as well as a survey result, research revealed the physical, emotional, and social benefits that African American seniors reported as a result of their participation in various activities offered in a multipurpose senior center in Atlanta Georgia. The study presents a social context in which African American seniors constructed their new third age identities that is different from the wide-spread negative images depicted by the mainstream about this minority group. Findings from this study increase the knowledge about African American seniors' participation in multipurpose facilities and provide a better understanding for the diverse socio-economic backgrounds of African American seniors. Study results will have policy implications for a better development of senior centers for minority population in the United States for the promotion of productive and successful aging.

An industry in the making: the emergence of institutional elder care in urban china.

Demographic shifts in China pose unprecedented challenges in the care of a rapidly growing older population. Sporadic reports suggest the recent emergence of institutional elder care in China, but little is currently known about this phenomenon. This study documents the growth, ownership, financing, staffing, and resident characteristics of elder care institutions using survey data collected in 2009 from Nanjing, China, supplemented with government registry data from seven additional major Chinese cities. Between one-half and two-thirds of facilities operating in these cities were founded in the last decade, primarily in the non-government sector. In Nanjing, government ownership dominated homes built before 1990 (96%) but was increasingly rare in the 1990s (60%) and in the 2000s (23%), a pattern observed in the other seven cities as well. In Nanjing, the average home now draws more than 80% of its daily operating revenues from private-pay or other non-government sources, and this share increases sharply with the recency of facility establishment. The majority (85%) of non-government-owned homes are receiving ongoing per-bed subsidies from the government. The lack of clinical staff characterizes the majority of study facilities; most care staff are rural migratory workers. There is considerable variability across facilities in the case-mix of residents in terms of functional dependence and acuity levels. These findings portray the emergence and rapid growth of a nascent industry of institutional long-term care in urban China and a fundamental shift in institutional ownership, financing, and clientele.

Institutional and individual autonomy: investigating predictors of attitudes toward institutional care in China.

This study examines the institutional and attitudinal changes in elder care homes in Tianjin, China. Based on a survey conducted in 2001 with 61 elder home managers and 265 elder residents, this study examines (1) factors that influence elder home managers' views about elder home development and (2) elders' evaluation of elder home quality and their levels of willingness to stay in such homes. Findings show that elder home managers view their autonomy in financing and administration as a very important factor for future development of an elder home industry. Elders' overall evaluation of elder home quality was high. Elders' willingness to stay in elder homes was related to two factors: their living arrangements prior to elder home placement and their assessment of the cost involved for such care. This suggests that the limited level of autonomy in private elder home administration and financing is hindering the development of elder homes. As adult children become increasingly unavailable due to the one-child policy and geographic mobility, institutional care for aging parents is likely to become a major option for familial care in China. The government should grant greater autonomy to private elder homes in order to encourage elder home development.

Social-economic context of parent care: explaining Chinese caregivers' psychological and emotional well-being.

This paper explores Chinese familial caregivers' depression and subjective burdens among the current caregivers. Data were collected in 1997-1999 with 110 caregivers who were then taking care of physically dependent parents or parents-in-law. Regression analyses were conducted to assess the factors that influence caregivers depression and subjective burden. Findings suggest that family and individual economic conditions are related to caregivers' depression. Caregivers' involvement in caregiving tasks is associated with caregivers' subjective burden. Poorer self-perceived health is related to higher report of caregivers' depression. The author argues that poorer health and unemployment at the time of drastic social and economic changes in China may have created psychological and emotional anxieties and depression for caregivers. The lack of financial and social stability may have deleterious effect for current caregivers in the future when they grow older and have to be cared for by their one-child generation children.

Aging, health care, and elder care: perpetuation of gender inequalities in China.

This article examines gender inequalities in the fields of health and familial elder care in China. Based on interviews conducted from 1997 to 1999 with 110 familial caregivers who were taking care of their physically dependent parents, this study explores various aspects of gender differences in both generations of care recipients and caregivers. The variables studied include health status, health care benefits, and income disparities among care recipients as well as caregiving task performance, employment status, and income levels among caregivers. Findings suggest that elderly female care recipients were more likely to receive no pension and medical benefits than their male counterparts; and female caregivers were more likely to earn less income when employed. Meanwhile, female caregivers were performing more hours of care tasks per week and were more involved in personal care and house chores even though they perceived their health as being poorer compared with their male counterparts. Male caregivers were more likely to provide financial assistance to parents. As the economic reforms continue and future family size reduces to a 4-2-1 inverted pyramid, the author argues that gender inequalities are likely to perpetuate or even worsen. Current female caregivers are likely to suffer from greater disadvantages in terms of reductions in income, retirement benefits, and health benefits due to their greater involvement with elder care. In turn, they are not going to have several adult children to share care responsibilities when they become older and need help.

Socialization or social structure: investigating predictors of attitudes toward filial responsibility among Chinese urban youth from one- and multiple-child families.

This study explores the influence of familial and social factors on the maturing cohort of China's one-child generation students' attitudes toward filial responsibilities. Based on survey data collected in 1997 and 1998 among 777 Chinese young adults, this research found that family economic conditions had a significant impact on young adults' attitudes; higher family income was positively related to respondents' willingness toward accepting filial responsibility; higher educational levels, though positively related to respondents' attitudes toward xiao, were negatively related to their commitment to parent care when they foresaw job and care conflicts. Family socialization was not found to enhance young adults' attitudes toward filial responsibility. Sharing the same household with grandparents and having dependent grandparents in the family were negatively associated with respondents' sense of obligation for parental care. Further, only children born after the one-child policy implementation scored lower than other children in their willingness to provide parental care when they foresaw job and care conflicts. The author argues that social structure, rather than socialization, plays an increasingly important role in shaping one-child generation students' attitudes toward filial responsibility in China, and will continue to do so in the future.

Through gendered lens:explaining Chinese caregivers' task performance and care reward.

The Chinese cultural norm of xiao, or filial piety, has long been held responsible for the practice of familial caregiving for older parents. Yet few explore the gendered nature of such a cultural practice in the current changing economic dynamics. Using data collected in 1997-1999 from 110 Chinese caregivers who were caring for physically dependent elder parents, this researcher explores the influence of changing economic conditions and Chinese cultural values in caregiver task performance and reward. Findings suggest that Chinese caregiving is highly gendered: Women are more likely to be unemployed and provide more personal care than men; sons are not more likely than daughters to provide financial assistance for parents. Chinese cultural values are playing an important role sanctioning caregiver task performance. Caregivers who believed in patrilocal norms provided more financial assistance; caregivers who reported higher social pressure provided more personal care. While the caregivers' report of social pressure is positively related to the caregivers' performance in personal care tasks, it is negatively related to caregiver reward. The author further explores the gendered implications for the changing economy and culture in China.

Chinese caregiving burden and the future burden of elder care in life-course perspective.

This article uses the life course perspective to combine micro- and macro-levels of analysis of caregiving burdens experienced by Chinese baby-boom cohort and then explores their elder care prospects. Based on survey interviews during 1997 and 1998 with 110 caregivers providing care to dependent parents or parents-in-law, this study finds that lower family income, fewer family members to assist with parental care, and care-recipients' higher levels of disability are contributors to higher levels of caregiver financial burden. Caregivers' greater involvement in provision of personal care contributes to their higher levels of objective burden. Interestingly, as duration of providing care lengthened, a reduction is noted in caregivers' subjective burden. Caregivers' report of social pressure in provision of parental care was found to increase their subjective burden. One can conclude that larger family size has been an important factor in relieving caregiver financial burden in the current caregiving situation when financial stress presents a major challenge to families with dependent elders under recent economic reforms. However, the lack of siblings to assist parental care in the future is likely to produce unimaginable stress on caregivers, creating not only financial burden but also objective and subjective burdens. In conclusion, the author suggests that social policy and service facilities at the macro-level, along with family size and cohesion at the micro-level, will be important factors helping determine the future effectiveness of elder care provision for baby boomers in China.