Preventing economic hardship among Chinese elderly in Hong Kong

Over the next 20 years, Hong Kong will face a rapidly aging population as the number of older adults aged 65 or above increases to approximately 1.4 million by 2021, that is, 17% of the total population. In 2001, there were 1.2 million adults aged 45-59. To assess the differences between these middle-aged adults and the current cohort of older adults, we identified the challenges that Hong Kong society will face in meeting the financial needs of older adults in the coming two decades. In this paper, we examine the retirement economic status of three groups of older adults: those who are financially independent, those who are financially supported by their adult children or children-in-law, and those who are receiving welfare assistance. We describe the current situations of these groups, prevailing social policy, future trends, and recommend policies for tackling problem areas.     

Cross-border retirement migration plan in Hong Kong middle-aged adults

The purpose of this study was to determine factors affecting cross-border retirement migration plans in Hong Kong using a life-course model as the framework. Data were based on a representative random sample of 1867 adults aged between 45 and 59, who were interviewed in person in 2001. About 6.7% of these respondents planned to migrate to Mainland China after retirement or when they become older. Those who planned to migrate to Mainland China (n=126) were more likely to be male, to be employed in white-collar occupations, to have attained higher levels of education, and to possess non-self-occupied properties, but less likely to live with adult children than those who did not plan to migrate at all (n=1699). The Government must examine and anticipate the socio-economic impact of this future retirement migration on Hong Kong and formulate measures to effectively reduce its negative consequences.     

Lessons on social and health disparities from older lesbians with alcoholism and the role of interventions to promote culturally competent services

ABSTRACT

Older adults who are lesbian, gay, bisexual, or transgender (LGBT) face greater health risks and possibly more costly care because of their reluctance to seek out health and long-term care services because of limited cultural sensitivity of service providers. This is particularly evident in older lesbians who face substantial risk of health problems associated with alcoholism and are less likely to be open with health care providers because of stigma combined with feelings of alienation, stress, and depression. An estimated 4.4 million older adults are predicted to have problems with alcohol by 2020, and the rates of alcohol-related hospitalizations are similar to those for heart attacks, creating exorbitant medical costs. More culturally competent health and long-term care may reduce health care costs by effectively addressing the dynamics of alcoholism, aging, and lesbian culture. Training initiatives such as those developed by the National Resource Center on LGBT Aging have begun to address the need of a more culturally competent aging services network. This article provides exemplars from empirical data on older lesbians with alcoholism to highlight some of the health, economic, and social disparities experienced in the aging LGBT community. Current interventions in the form of cultural competence training for service providers are presented as a potential step toward addressing health disparities among LGBT older adults.     

Community Integration of Older People with Developmental Disabilities in Hong Kong

ABSTRACT

To understand the community integration of adults with developmental disabilities in Hong Kong, a comprehensive measure includes four dimensions, pertaining to social activity, social services, interpersonal behavior, and people involved in social interaction. Applying this measure to 692 adults (aged 15–62), the territory-wide study finds that these adults lack company for out-of-home activities and community activities despite their higher knowledge, assertiveness, social interaction, and feeling accepted in the community. With the strengthening of many conditions (including knowledge and community support) for community integration, the adults tend to have greater need for empowerment to enhance their active participation in community activities.     

What contributes to ethnic minorities’ identification with Hong Kong? The cases of South Asian and Filipino youth

ABSTRACT

The context of Hong Kong has not always been favourable for the integration of ethnic minorities, who face various difficulties in education, employment, and daily life. Research, however, has shown that many minorities, particularly the youth, have developed a fair sense of belonging to the city. To explore this puzzle, this study conducted semi-structured interviews with 20 South Asian and Filipino youth and identified four main factors that may be associated with their local identification. They are (1) experiencing less discrimination, (2) achieving a higher level of sociocultural adaptation, (3) having an inclusive conception of Hong Kong identity, and (4) claiming to have received more social benefits. The findings suggest that the context of Hong Kong is not entirely detrimental for ethnic minorities to develop a local identification. Ethnic minorities themselves are also active agents in the construction of identity. Theoretical and policy implications of the findings are discussed.     

Changing Needs and Changing Service Delivery for Long-Term Care in Hong Kong

Summary

Both the need for and delivery of long-term care in Hong Kong are shaped by the interaction of the traditional and modern. Rapid social change is affecting traditional family structures and roles in care of the elderly, resulting in increased demand for formal care, which to date has been provided mainly by way of residential care. This growth of demand will escalate with rapid population aging in coming decades. In response to this burgeoning demand, current planning is seeking to reshape the established service system and tackle problems in service delivery in ways that will address the bias towards residential care and improve quality of care.     

Coping strategies used by LGB older adults in facing and anticipating health challenges: A narrative analysis

ABSTRACT

Given that lesbian, gay, and bisexual (LGB) older adults face notable health disparities compared to their heterosexual counterparts, there is a need for understanding how LGB adults cope with health challenges in late life. The current study analyzes narratives from nine LGB adults age 65 and older living in an urban area in the Southeast United States. Participants spoke of coping strategies related to health promotion behaviors, shifting perspectives of health and body, trusting in spirituality for comfort, and accepting the end of life. We discuss implications for social services professionals who work with older LGB adults and for future research.     

Why ‘Reunion in Democracy’ fails? – the past and the future of a colonial city

ABSTRACT

This paper addresses the current political predicament in Hong Kong. However, rather than offering a casual political commentary on the current state of identity politics of Hong Kong, it offers a critical and historical evaluation of the ideas and practices of ‘Reunion in Democracy’ in the past decades.     

Prevalence and risk and protective factors associated with HIV-related behavior among transgender people in Hong Kong

Abstract

This paper presents findings from the first large-scale quantitative study into HIV-related behavior among transgender people in Hong Kong. A survey of 195 transgender people found that only one-third of those who had engaged in sexual behavior in the past 3?months reported consistent condom use. Stable relationships, beliefs in low HIV transmission risk, and condom inaccessibility were cited as reasons for inconsistent condom use. The HIV testing figures were also strikingly low. This study demonstrates an urgent need for addressing HIV issues among transgender people in Hong Kong as there are currently no such specific services.     

Resource Accessibility and Walkability Among Older Adults in Extended-Stay Hotels

Older adults represent a large and growing population group in the United States. This population cohort is projected to grow to 72.1 million, or 19% of the total population, by 2030, up from 40 million in 2010 (Administration on Aging, 2011; Federal Interagency Forum on Aging-Related Statistics, 2012). Despite reported decreases in the proportion of older adults living in poverty in recent years, inequities prevail. Approximately 40% of older American households reported housing cost burdens¹Cost burdens are expenditures on housing and utilities that exceed 30% of household income. (Federal Interagency Forum on Aging-Related Statistics, 2012). Many of these low-income older adults live in socially and economically marginalized positions, and housing them remains a major challenge complicated by (a) limited affordable housing options and (b) chronic health conditions that seriously undermine long-term health and mobility. In a study on the impacts of public housing transformation in Atlanta, Oakley, Reid, & Ruel (2011) reported that 26% of seniors entered public housing because of a health condition or disability. According to Smith (2006), seniors in public housing are in worse health than other older Americans, even other poor older Americans suffering from such chronic health conditions as hypertension, diabetes, arthritis, and asthma. Despite these realities, Ball (2012) has noted that older adults receive little attention in comprehensive development planning beyond specialized age-segregated retirement and care communities. Salkin (2009) echoes similar concerns about the tendency toward housing initiatives and designs for more affluent older adults. She commented that most states have focused attention on programs that are best suited for seniors who do not have the same income limitations as those who are truly on fixed incomes and living close to the poverty level (Salkin, 2009). While public housing remains the predominant affordable housing option for low-income older adults, such housing is out of reach for many low-income older adults who find themselves displaced and homeless. As a result, some of these adults move into extended-stay hotels to remain sheltered.     

The Impact of AIDS on Intergenerational Relationships in Africa

Abstract

This paper describes die impact of AIDS on intergenerational relationships in Africa (especially Sub-Saharan Africa). The AIDS infection in Sub-Saharan Africa has expanded astronomically with up to 18.5 million living with the disease. Young adults between the ages of 14 and 49 are most likely to be infected. In the countries of Sub-Saharan Africa, three levels of HIV/AIDS infection among adults can be identified-hardest hit, high, and moderate. This ranges from 3.6% for moderate level to 35.8% for the hardest hit. The situation has changed the youth population profile and has numerous quality of life implications for young people, older adults, and a multi-dimensional impact on community life.

With the adverse socioeconomic and psychological effect of AIDS, interactions between members of the different generations are made difficult-relationships are becoming more of a burden than a mutual source of satisfaction. Children and young adults are losing their parents and mentors, and sometimes have to take care of their infected and dying parents at a very early stage in life. The older population is now losing its social and economic support, which hitherto, they have drawn from their adult children, and at the same time, they are assuming a new caregiving role to either their infected and affected children or grandchildren, or both.

Hope exists if the trend is checked by AIDS prevention efforts with examples drawn from countries like Uganda, Senegal, and Nigeria. But since there are some victims already, efforts should be made to help them cope with the stress and adverse effects of the disease. Governmental policies should also aim at assisting victims and volunteers financially. As part of the strategy, intergenerational relationships at family, organizational and community levels should be strengthened. Reinforcing the value of being one's “brother's keeper” both as individuals and groups/organizations is crucial at this time of crisis.     

Living Arrangements and Informal Support for the Elderly

ABSTRACT

A network of informal care and support provided by family, friends and neighbors often forms the basis for elderly care. Changes in the structure of Chinese family alter this supportive function, and changes in traditional values affect the nature of the network and support provided. This is especially so in modernized Hong Kong where the traditional role of the family and especially children's duty of care for their aged parents (“filial piety”) may be weakening. This proposition was investigated by a qualitative study involving in-depth interviews with 50 older persons in a modern new town (Tuen Mun) in Hong Kong. Living arrangements, geographical proximity and the quality of relationships between potential caregivers and the elderly affected needs for and provision of informal support. Traditional Confucian filial piety is undergoing modification, perhaps erosion, implying ongoing changes in inter-generational relations in this modernized Asian society.     

An Intergenerational Perspective on Grandparent Roles

Abstract

This study provides an intergenerational perspective on grandparent roles. Data was collected from young parents (N = 105) and middle-age and older adults (N = 105). Both groups identified multiple roles as important for grandparents to initiate with young grandchildren: these included being a playmate as well as a friend, teacher, and role model. Intergenerational differences were also found with middle-age and older adults more likely than young parents to rank religious guide (p < .001) and family historian (p < .05) as important roles to enact with young grandchildren. However, the young parents were more likely than the older participants to predict that grandparents would be remembered by their grandchildren as fun, having high values, being a role model, and financially supportive (p < .001). Recommendations for future intergenerational research are recommended.     

Geographic distance and intergenerational relationships in Chinese migrant families

ABSTRACT

This study examines the effect of adult Chinese migrants’ geographic distance from home on their intergenerational relationships with parents who remain behind. We compared monetary and family care support as well as emotional relationships among four parent-child groups: older adults and international migrant children, older adults and internal migrant children (who migrated to other cities in China), older adults and coresiding children, and older adults and local children (living in the same city as their parents). Data were derived from 332 older adults in Beijing, China, with at least one child who migrated to another country or city. Results from chi-square tests, anaylsis of variance (ANOVA) tests, and regression analyses indicate that international and internal migrant children maintain similar intergenerational relationships with their parents, and that both of those groups are less likely than coresiding and local children to have family care exchanges and emotionally close relationships with their parents. The results may help professionals develop supportive services and policies for older adults in migrant families.     

Assessing Capacity in the Setting of Self-Neglect: Development of a Novel Screening Tool for Decision-Making Capacity

ABSTRACT

Compared with older adults with disabilities and those who autonomously choose to live in squalor, self-neglect syndrome arises from a predicate state of vulnerability in frail older adults. This state of vulnerability is characteristically associated with a decline in decision-making capacity regarding the ability to care for and protect oneself. We developed the COMP Screen to evaluate vulnerable older adults to identify potential gaps in decision-making capacity using a screening tool. A total of 182 older adults were evaluated and consistent declines in cognitive ability and decision-making processes were present in this population. However, there were no significant differences between elders referred for self-neglect and matched older adults. These findings suggest that declines in decision-making processes are not uncommon in vulnerable older adults but traditional conceptualizations of decision-making capacity may be inadequate for differentiating the capacity for self-care and protection in elders who self-neglect.     

Age-Friendly Neighbourhoods as Civic Participation: Implementation of an Active Ageing Policy in Hong Kong

In response to challenges brought by population ageing, Hong Kong has adopted an active ageing policy framework and built age-friendly neighbourhoods to encourage the participation of older people. This article distinguishes between the civic and political participation and emphasizes active involvement in community and neighbourhood activities as a way to encourage the civic engagement of older adults. The promotion of age-friendliness is set at two levels: concerning policy and practical/operational issues, both of which are interrelated with the purpose of offering civic engagement opportunities for older people. The experiences of Hong Kong reflect both top-down and bottom-up approaches, where civic participation is promoted by encouraging life-long learning and developing caring communities, as well as carrying out a variety of neighourhood programmes. It is suggested that different stakeholders, such as older adults, NGOs and other social organizations, shall all be included and play important roles in promoting civic participation of the elderly through creating a conducive environment. The initiatives, whether these are in policy or at operational levels, should be integrated into actions that are aimed to enhance quality of life for all residents and create a more age-friendly neighbourhood.     

Developmental Recapitulation in Adaptation to Vision Loss Among Middle-Age and Older Adults

Abstract

Previous research has suggested that a recapitulation of developmental stages occurs during periods of readjustment in situations involving significant contextual or environmental change. The purpose of this paper is to examine if evidence exists for developmental recapitulation among middle-age and older adults adapting to recent vision impairment. Psychosocial development was operationalized in accordance with Erikson's stage theory (Erikson, 1963, 1980) and measured using the Inventory of Psychosocial Balance (Domino & Affonso, 1990). Data were obtained from 99 middle-age and 96 older adult vision rehabilitation service applicants and compared with normative scale data for these age groups. Results found significantly lower Trust, Initiative, Industry, and Intimacy scores for middle-age adults and lower Initiative and Industry scores for older adults. Unexpectedly, middle-age adults who were visually impaired had significantly higher Integrity scores compared to the normative group. Findings provide preliminary evidence for developmental recapitulation of psychosocial stages in the process of adaptation to vision loss in middle age and older adults. Implications of these findings are discussed in terms of social work practice with this population and future research.