The effect of health status and living arrangements on long term care models among older Chinese: A cross-sectional study

Abstract

BackgroundCurrently, there are many studies focusing on the influencing factors of the elderly people’s living arrangements or health status, but little is known about the relationship between living arrangements or health status and long-term care models for the old-age, especially the joint effects.ObjectiveWe aimed to assess the effects of health status and living arrangements on long-term care models (LTCM) among the elderly of Xiamen, China, especially their cumulative joint effects.MethodsA total of 14,373 participants aged ≥ 60 years by multistage sampling in Xiamen of China were enrolled. Multinomial logistic regression was used to estimate the Odds ratios (ORs) regressing LTCM on health status and living arrangements using the Anderson model as theoretical framework.ResultsTotally, 14,292 valid questionnaires were obtained, of which 86.37% selected home care. With the increase of disability degree, older people are more likely to choose institutional care, compared to living alone (ORs = 1.75, 2.06, 4.00, 4.01 for the “relatively independent’, “mild disability’, “moderate disability’, and “total disability’, respectively, in comparison with “completely independent’). The elderly living with children and other family members preferred to choose home care. (ORs = 0.50, 0.39, 0.40, and 0.43 for the “living with children’, “living with spouse’, “living with children and spouse’, and “living with others’, respectively, in comparison with “alone’). Additionally, residence, number of children, education level, and feelings of loneliness were the determinants of the choice of social pension.ConclusionA multitude of older people are trended to choose home care in Xiamen of China. There was an interaction and joint effect between the degree of disability and the living arrangements on LTCM. Therefore, policymakers should pay close attention to care for those living alone, childless, and disabled elders to meet their care needs, especially in home care. In addition, the social construction of facilities for elders in rural areas should be strengthened.

Older people living alone in Shanghai: A questionnaire survey of their life experience

“…The phenomenon of population ageing is a major social problem around the world, and especially in China, the most populous country (Zhang, Zeng, & Fang, ). In 2000, China reached the threshold of an ageing society.…”

“…By the end of 2016, there were more than 230 million older people, accounting for 16.7% of China's total population (National Bureau of Statistics of China, ) and reflecting a significant demographic transition. By 2050, it is estimated that the proportion of older people will exceed 30% (Zhang et al, ). Traditionally, in the Chinese culture junior family members are morally obliged to respect and take care of their older parents.…”

Factors associated with preferences for elderly care mode and choice of caregivers among parents who lost their only child in a central China city

“…13,14 Maybe due to lack of care and help from children, they worried that with age and deteriorating physical condition, it is difficult to cope with the difficulties of life in their later years. The study found that 47.4% parents chose community or home care, and 52.6% parents chose institutional care.…”

“…The results of this study showed that 52.6% of parents chose institutional care in their later lives, and this proportion was much higher than the proportion of ordinary older adults. 13,14 Maybe due to lack of care and help from children, they worried that with age and deteriorating physical condition, it is difficult to cope with the difficulties of life in their later years. They had no other better choices, thinking that only nursing homes can provide them with relatively reliable care.…”

Social support and care needs of the disabled elderly population: An empirical study based on survey data from Beijing, China

“…A point worth mentioning is that care by one's family or son(s)/daughter(s) was the main form of routine support received by the disabled elderly. Previous studies have found older Chinese with the ability to live independently also tend to reside with family rather than live in a nursing home (18). This phenomenon can be explained by the fact that residing with and caring for elderly parents is still the predominant way that adult son(s)/daughter(s) in modern China express filial piety -a key virtue in Chinese culture (19).…”