Gender and family structures affecting intergenerational support from adult children to older parents: A cross-national study in a developing country.

In Latin America, informal support from adult children to their older parents ("upward support") is crucial with an aging population and insufficient coverage of social protection systems. This article examines variables associated with upward support, distinguishing by gender of parents and their children. The research design is quantitative, correlational, and cross-sectional. It is based on primary survey data collected by the authors for the study. The authors hypothesized that upward support depends on children's opportunities to provide support and on the needs of parents. The results show that upward support depends more on children's opportunities than on parents' needs, although upward support is higher for parents with poorer health. Daughters are more supportive than sons, but sibling characteristics do not moderate associations between children's gender and receipt of support. Cohabiting with the parent, receiving support from the parent, and having a good relationship were also associated with greater upward support. Therefore, policies should consider the gender of adult children when allocating resources to older people.

Grandparent-grandchild relationships, generativity, subjective well-being and self-rated health of older people in Chile.

With increasing life expectancy, grandparents and grandchildren have more years available to share. Furthermore, with lower fertility rates and fewer grandchildren, relationships can be more frequent and profound. Intergenerational relationships are expected to be associated with older people's quality of life, especially in Latin American countries such as Chile, with high intergenerational co-residence and contact between generations. This research aims to analyze the associations between the characteristics of intergenerational relationships and grandparents' subjective well-being (Diener Scale and Satisfaction) and self-rated health. The novelty stems from including the structural characteristics of relationships with grandchildren (frequency of contact, closeness, and care), the activities they share (generativity), and the quality of relationships (ambivalence). This study is based on data from a specific face-to-face grandparenting survey conducted on a sample of 464 grandparents in January 2020. It is representative of older Chilean grandparents living in private dwellings. Multiple logistic and ordinary regression models were estimated using the Diener Scale, unique satisfaction question, and health self-perception. The results demonstrated that subjective well-being, but not self-rated health, was highly associated with the characteristics of intergenerational relationships, especially with the quality of relationships and with generative activities such as recreational activities and family identity. In conclusion, intergenerational relationships' quality and content are strongly associated with subjective well-being in old age, but not with health self-perception. Even in a Latin American country like Chile, with high co-residence and intergenerational contact, the variations in quality and generativity activities significantly explain the variations in subjective well-being. For this reason, policies for the promotion of well-being in older people must consider the family environment in which older people live, encompassing wider family networks, including grandchildren.

A longitudinal study monitoring the quality of life in a national cohort of older adults in Chile before and during the COVID-19 outbreak.

BACKGROUND: Confinement during the COVID-19 pandemic has placed great stress on older adults, which may be affecting their quality of life. Thus, this study aims to describe the changes in mental and physical health, isolation and loneliness, residence and socioeconomic resources in a national cohort of Chilean older adults before and during the COVID-19 outbreak. It also analyzes the changes in depressive symptoms by changes in the other quality of life indicators before and during the COVID-19 outbreak. Possible methodological biases of telephone surveys in older adults living in non-developed countries are also discussed. METHODS: Between June and September 2020, a random subsample of 720 people who had participated in the face-to-face V National Survey on Quality of Life in Older Adults in Chile conducted at the end of 2019 was followed up by telephone. Descriptive bivariate analyses were performed using t-test and non-parametric tests for independent variables, comparing the baseline sample with the current 2020 follow-up sample during the peak of the pandemic outbreak in Latin America. Furthermore, descriptive bivariate analysis through t-test and non-parametric test for paired samples compared the follow-up subsample at baseline with the not-included sample, examining possible biases of the telephone interview compared with the face-to-face interview. RESULTS: In the panel, there was no variation in self-rated health. The health symptoms that worsened were memory, stomach, and mood problems. Depressive symptoms and anxiety increased; similarly, smartphone users, social contacts, intergenerational co-residence and resilience increased. The telephone follow-up sample had a higher educational level and greater smartphone use than those not included in the subsample. CONCLUSIONS: Although some physical and mental health indicators have worsened during the pandemic, older adults mobilized resources that could allow them to maintain their quality of life, such as improved resilience. Thus, these findings can guide future research and the development of efficient strategies to improve these resources among older adults to ensure wellbeing.

Does the selective attrition of a panel survey of older people affect the multivariate estimations of subjective well-being?

PURPOSE: The increased population aging has resulted in a growing need for longitudinal studies about the quality of life among older people. Nevertheless, the results of these investigations could be biased because more disadvantaged people leave the original sample. The purpose of this study is to examine how the selective attrition observed in a panel survey affect multivariate models of subjective well-being (SWB). The question is if we could do reliable longitudinal investigations concerning the predictors of SWB in old age. METHODS: This paper examines attrition in a panel of older people in Chile. Attrition was evaluated in the variables that affect elderly SWB. Probit models were fitted to compare dropouts with nondropouts. Then, multivariate probit models were estimated on satisfaction and depressive symptoms, comparing dropouts and nondropouts. Finally, we compared weighted and unweighted multivariate probit models on SWB. RESULTS: The attrition rate in 2 years was 38.8%, including deaths and 32.9%, excluding them. Survey dropouts had lower satisfaction but not higher depressive symptoms. Among SWB predictors, people without a partner and with lower self-efficacy abandoned more the study. When applying the Becketti, Gould, Lillard, and Welch test, the probit coefficients of the predictor variables on SWB outcome variables were similar for dropouts and nondropouts. Finally, the comparison of multivariate models on SWB with weighting methods did not find substantial differences in the explanatory coefficients. CONCLUSION: Although some predictors of attrition were associated with SWB, attrition did not produce biased estimates in multivariate models of life satisfaction life or depressive symptoms in old age.

Stressful Events in Old Age: Who are Most Exposed and Who are Most Likely to Overcome Them.

Objectives: This study investigated self-reported events that were rated as stressful and being affecting wellbeing among older people. It also examined the variables associated with the perception of overcoming these stressful events. Methods: Face-to-face survey on a representative sample of 1,431 older people in Santiago-Chile. Instruments included open-ended questions for distinguishing events as losses, problems, conflicts, and others' difficulties. The associations between the occurrence and overcoming of events with individual and social characteristics were examined through multivariate logistic regression. Results: 39.5% mentioned at least one stressful event, being mostly perceived as solvable problems rather than losses. Higher-income, better health, self-efficacy, and social support were associated with a higher perception of event overcoming. Conclusion: The occurrence and the probability of events' overcoming does not increase in old-old age in this sample group. Better health and individual and social resources such as self-efficacy and social support, are protective resources for overcoming the stressful events, but they are not generally considered in public policies.

[Health effects of dependent older people caregiving by family members]. / El efecto del cuidado informal en la salud de los cuidadores familiares de personas mayores dependientes en Chile.

BACKGROUND: Care required by dependent older people is mostly provided by close family members. Caregiving is a demanding task, negatively affecting the physical and mental health of the caregiver. AIM: To describe the sociodemographic characteristics of informal caregivers of dependent elderly people in Chile and to evaluate the effect of providing care on the health of caregivers. MATERIAL AND METHODS: Data from the Economic Characterization Survey (CASEN) done in 2015 was used. Using as index cases older people who were receiving care from a family member, 4,313 informal caregivers were identified, whose characteristics were analyzed. Descriptive statistics and matching through propensity score were estimated, based on a logistic model, which included covariates such as sex, age, marital status, education, occupation, and income. Finally, the effect of being an informal caregiver versus not being a caregiver on the perception of health was calculated. RESULTS: Forty four percent of the caregivers were offspring and 33.6% couples. Sixty seven percent were women, with a mean age of 56.5 years. Half of them had a partner, 43% had basic education or less, and 61% were inactive. Being a caregiver had a significant effect of health perception. CONCLUSIONS: People belonging to certain more vulnerable groups are more likely to assume caregiving. Providing care to a dependent older person has a negative effect on health perception.

El efecto del cuidado informal en la salud de los cuidadores familiares de personas mayores dependientes en Chile / Health effects of dependent older people caregiving by family members

Background: Care required by dependent older people is mostly provided by close family members. Caregiving is a demanding task, negatively affecting the physical and mental health of the caregiver. Aim: To describe the sociodemographic characteristics of informal caregivers of dependent elderly people in Chile and to evaluate the effect of providing care on the health of caregivers. Material and Methods: Data from the Economic Characterization Survey (CASEN) done in 2015 was used. Using as index cases older people who were receiving care from a family member, 4,313 informal caregivers were identified, whose characteristics were analyzed. Descriptive statistics and matching through propensity score were estimated, based on a logistic model, which included covariates such as sex, age, marital status, education, occupation, and income. Finally, the effect of being an informal caregiver versus not being a caregiver on the perception of health was calculated. Results. Forty four percent of the caregivers were offspring and 33.6% couples. Sixty seven percent were women, with a mean age of 56.5 years. Half of them had a partner, 43% had basic education or less, and 61% were inactive. Being a caregiver had a significant effect of health perception. Conclusions: People belonging to certain more vulnerable groups are more likely to assume caregiving. Providing care to a dependent older person has a negative effect on health perception.

Develando la experiencia de un grupo de personas mayores en un centro de día / Unveiling the experience of a group of elderly people in a day care center

Objetivo: El envejecimiento de la población representa uno de los grandes desafíos para Latinoamérica, tanto para los servicios de salud como para los servicios sociales de apoyo a las personas mayores. La introducción de los centros de día para personas mayores, como un nuevo servicio gerontológico, se transformará en una pieza crítica de los servicios ofrecidos a las personas mayores que viven en la comunidad, generando las bases para construir un sistema de cuidado y atención especializada dirigida a este grupo etario. El objetivo de este estudio es evaluar la experiencia de un grupo de personas mayores pertenecientes a un centro de día de una municipalidad de Santiago, Chile. Métodos: Estudio cualitativo descriptivo con uso de técnica de grupo focal y análisis de contenido que devela la experiencia de 37 personas mayores asistentes a un centro de día. Resultados: Los principales resultados de este estudio fueron: a) mejoría en la funcionalidad, b) empoderamiento de las personas mayores y c) mayor inserción social. Conclusiones: La experiencia de las personas mayores es evaluada como positiva, reconociendo mejorías en aspectos claves de su vida cotidiana y que tienen el potencial de contribuir a mejorar y fortalecer la funcionalidad y aspectos de la salud mental de las personas mayores. Estos resultados aportan evidencia científica latinoamericana a la evaluación de la experiencia de las personas mayores con este nuevo servicio geriátrico

Background: Chile is a country that will continue aged at an accelerated rate as a result of a progressive decline in the birth rate, adequate access to health and a sustained increase in life expectancy. The aging population is one of the major challenges for the country as well as for health and for social services to support aged population. Introducing the Day Care Centers for aged people, as a new gerontological service, will become a critical part of the services offered to the elderly living in the community, creating the foundations for an specialized system of care directed this age group. The aim of this study is to evaluate the experience of a group of elderly people from a day care center of a municipality of the Metropolitan Region. Methods: Descriptive qualitative study with focus group and content analysis that reveals the experience of 37 older people attending at day care center. Results: The main results of this study were: (a) improvement in functionality, (b) empowerment of older persons, and (c) greater social inclusion. Conclusion: The experience of older persons is assessed as positive by themselves. Older people recognized improvements in key aspects of their daily lives and have the potential to contribute to improving and strengthening the functionality and mental health of elderly people. These results provide evidence for national evaluation of this new geriatric service