Family care-giving and living arrangements of functionally impaired elders in rural China

Abstract

China has seen a rapid decline of the traditional multi-generational household and an increase in rural-to-urban migration, raising concerns about a possible breakdown of the informal support system. Against this background, the paper looks at family care-giving (or the absence thereof) to parents in three different living arrangements: with any child or child-in-law (co-resident); independent with at least one child living in the same community (networked); and without any children in either the household or the community (isolated). It also compares the care-giving arrangements of single elders to those living with a spouse. The sample, which is derived from the comprehensive China Health and Retirement Longitudinal Study (CHARLS), contains data on 887 functionally impaired individuals aged 60 and above. The findings suggest that married parents are mostly cared for by their spouse, even if they co-reside with adult children. Proximity to children is particularly important for single elders, who are more likely to lack a care-giver when living independently. There appears to be a hierarchy in family care responsibilities, where children step in as care-givers only when the spouse is no longer able to fulfil this role. While these findings imply a significant deviation from traditional practices and norms of ‘filial piety’, they can be interpreted as a rational adaptation to the changed economic circumstances in rural China.

Preferences for Formal Social Care in Rural and Urban China: Evidence from a National Survey

“…This study investigated the preferred care arrangements among the Chinese older population. Most of the existing Chinese studies have focused on the actual utilization of social care and its determinants, but less is known about people's care preferences (Gruijters, 2017;Lu, Liu, & Piggot, 2015). A systematic review conducted by Lehnert et al (2019) identified five China-based studies, among which four focus on Hong Kong.…”

“…When older people make care plans for the future, offspring seem to be the most important social support resources under consideration. It is also interesting to note that while living with a spouse is an important predictor of actual utilization of family care (Gruijters, 2017), it makes little difference to older people's care preferences. This once again shows that the determinants of actual utilization of care do not necessarily overlap with those of preferred care arrangements.…”

The Protective Effects of Informal Care Receipt Against the Progression of Functional Limitations Among Chinese Older People

“…However, it is a viable option for some adult children to take turns providing care or sharing the caring tasks. In comparison, a spouse is usually the main caregiver, if not the sole caregiver, and thus is fully exposed to the health risks of caregiving (Gruijters, 2017). Therefore, our second hypothesis can be summarised as follows: H2: The protective effects are stronger among older people receiving informal care from their children.…”

Trends in women's informal eldercare in China, 1991–2011: an age–period–cohort analysis

“…Historically, besides spouses, both adult sons and daughters played critical roles in providing care to frail elderly relatives when the multigenerational household was the predominant form. This is still the case in rural China, where formal long-term care facilities are notably absent, leaving sons and daughters-in-law to co-reside with and care for their elders (Gruijters, 2017). Evidence shows that, for the collective welfare of the household, daughters are more likely to provide direct eldercare ( i.e.…”