Utilisation willingness for institutional care by the elderly: a comparative study of empty nesters and non-empty nesters in Shandong, China

Abstract

IntroductionInstitutional care has been strongly promoted in China to meet seniors’ long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors.MethodsA total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters.ResultsOur study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters.ConclusionsThe government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.

Effects of individual, family and community factors on the willingness of institutional elder care: a cross-sectional survey of the elderly in China

“…People in their 80s and above had 2.250 times more willingness to live in elder care institutions than the group aged 60–69 years. The same conclusion was drawn from another study 22. Another study pointed out that those in advanced old age are much more likely to have elder care needs, including physical and psychological 23.…”

Utilization willingness of institutional care between disabled and non-disabled seniors: evidence from Jiangsu, China

“…Compared with studies of other provinces, the proportion was also lower than Beijing (30%) [29], Henan (16.1%) [16] and Guizhou (38.5%) [14]. However, it was higher than Shandong (8.5%) [30] and Zhejiang province [31]. In different circumstance, there is a large disparity of preference for institutional care among the seniors.…”

“…The seniors with better education are open-minded, who will be easily to accept the new idea in view of diminishing family size and increasing geographic mobility [35]. In addition, disabled seniors living alone were more likely to choose institutional care because they find it hard to obtain informal support [30, 38].…”

Multidimensional factors affecting care needs in daily living among community‐dwelling older adults: A structural equation modelling approach

“…Previous findings provide some support for the results. Older adults with higher income are more likely to live alone, and household income is one of the predictors of empty‐nest couples being willing to have institutional care (Qian et al., 2018). Furthermore, physical and mental health acts as the mediator between EF and CNDL.…”