Older women and family care in Hong Kong: differences in filial expectation and practices

Cultural aspects of aging have great importance on how older women and men are being treated, in particular in Asia where patriarchal practices dominate. Further, changes in the structure of the Chinese family alter this supportive function, and changes in traditional values affect the nature of the care and support provided to older women and men. This proposition was investigated by a quantitative study involving a survey of 390 older persons in Hong Kong. There are great discrepancies in informal support for older women and men. Older women are less likely to live with adult children; more likely to need financial assistance; and more likely to receive poor informal support. There is evidence that informal support for the elderly is changing in Hong Kong, and older women are being disadvantaged, experiencing insufficient and unavailability of informal support.     

Women's financial planning for retirement: the impact of disruptive life events

Providing care for an aged parent has immediate financial, emotional, psychological, and physical consequences for the primary caregiver. This pilot study of 138 middle aged and older females analyzes the long term financial consequences of providing care to aged relatives for female caregivers. The impact of this disruptive life event (e.g., caring for an aged relative) on retirement planning among middle aged and older adult women was analyzed using quantitative data collected from women residing in the Midwest region of the United States.     

Parental marital disruption and intergenerational transfers: An analysis of lone elderly parents and their children

Although one of the most marked demographic trends observed over the twentieth century is the increased rate of divorce, relatively little research has explored the effects of these changing marital patterns in the context of an aging society. Using a sample of lone elderly parents and their adult children, we analyze the direct and indirect effects of marital disruption on four important dimensions of intergenerational transfers: coresidence, financial assistance, adult children's provision of informal care, and parental purchase of paid care. Our findings suggest that divorce has deleterious effects on intergenerational transfers, particularly for elderly fathers. Remarriage further reduces exchange. Our results reveal that parents engage in lower levels of transfers with stepchildren relative to biological children. Moreover, intergenerational transfers are sensitive to characteristics of biological children but not to those of stepchildren. Taken together, these results suggest that exchange at the end of the life course continues to be adversely affected by marital disruption.     

Perception of health,well-being,and quality of life in female caregivers: Comparative study of a sample of adult and older women in Spain

In a study on informal or unpaid care, it is difficult to identify the consequences and effects of care provision on the caregiver’s daily life. Thus, it is important to analyze the perceptions of the individual caregiver. This study describes the perceptions of health, well-being, support networks, and quality of life of 13 women aged between 45 and 70 years after completing an intervention program. The data indicate that caregivers’ health and quality of life worsen with the intervention, and their well-being and social relations (through new technologies) improve.     

Long-term care in Spain: Difficulties in professionalizing services

The aim of this article is to analyze the difficulties in professionalizing the long-term care system in Spain. Since 2006, the new Spanish law has recognized care as a subjective right, and regulations are being designed to create a framework for its professionalization. Nowadays, family remains the most important group of providers who care for their elders, and women remain the main informal caregivers. Why do families resist using public long-term care services and professional carers included in the new law? The hypothesis highlights sociocultural factors as an obstacle to professionalization of long-term care services in addition to political and economic factors. The results show qualitative data about expectations, preferences, and discourses that women caregivers have in relation to their responsibility. The empirical material includes 25 interviews with different profiles of caregivers and six focus groups with family caregivers. The article suggests that the Spanish ideal of care is a problem for the professionalization of services because the family remains as the main provider of care—without specific skills, knowledge, and abilities.     

Through gendered lens:explaining Chinese caregivers' task performance and care reward

The Chinese cultural norm of xiao, or filial piety, has long been held responsible for the practice of familial caregiving for older parents. Yet few explore the gendered nature of such a cultural practice in the current changing economic dynamics. Using data collected in 1997-1999 from 110 Chinese caregivers who were caring for physically dependent elder parents, this researcher explores the influence of changing economic conditions and Chinese cultural values in caregiver task performance and reward. Findings suggest that Chinese caregiving is highly gendered: Women are more likely to be unemployed and provide more personal care than men; sons are not more likely than daughters to provide financial assistance for parents. Chinese cultural values are playing an important role sanctioning caregiver task performance. Caregivers who believed in patrilocal norms provided more financial assistance; caregivers who reported higher social pressure provided more personal care. While the caregivers' report of social pressure is positively related to the caregivers' performance in personal care tasks, it is negatively related to caregiver reward. The author further explores the gendered implications for the changing economy and culture in China.     

Initiation of the process of adult role entry

Among the most significant events marking the transition to adulthood are role changes involving the assumption of adult responsibilities. These include entry into the adult roles of worker, spouse, and parent. Because entry into one adult role tends to have implications for entry into other adult roles, the ages at which these role changes occur are related. It is therefore instructive to view the process of adult role entry as a process that is initiated when the first of several role changes occurs. The purpose of this paper is to examine initiation of the process of adult role entry. Data from a fifteen-year followup study of high school students originally surveyed in 1957–58 and resurveyed in 1973–74 are analyzed to determine which of several role changes initiated the process of adult role entry and the age at which the process was initiated for cohorts born during the early 1940s. A model predicting the age at initiation of the process is estimated, and the parameters of that model are compared with the parameters of comparable models predicting educational attainment and the timing of exit from the student role.This research was supported by Grant Nos. R01-HD16164 and R01-HD18596 from the National Institute of Child Health and Human Development. I am indebted to Peter H. Rossi and James S. Coleman for their assistance and support during the collection of data on which the research was based. The assistance of Peter J. Hodsdon and Lillian L. Southwick in processing the data and Pamela Navatta in typing the paper is also gratefully acknowledged.     

Staff Member Reactions to Same-Gender,Resident-to-Resident Sexual Behavior Within Long-Term Care Facilities

The current study assesses ageism and heterosexism relating to older adult sexual activity within long-term care facilities. To assess caregiver reactions, 153 residential care facility staff members read one of three vignettes. Each vignette described a scenario in which a staff member walks in on two residents (male/female, male/male, or female/female) engaging in sexual activity. Although no main effects were discovered for vignette type, exploratory analyses revealed that the facility where participants were employed was significantly related to their ratings of approval. Furthermore, an interaction effect between vignette and facility types was also discovered for caregivers’ approval of sexual activity among residents. Additionally, a strong overall approval rating of older adult sexuality was reported by staff members. The results of this study warrant that further research is necessary regarding older adults’ perception of caregiver bias, as well as further investigation of caregivers’ perceptions of older adults’ sexual activity.     

Being “easy”: Women’s desire to accept help in later life

ABSTRACT

This article examines the concept of being “easy” as a quality that female caregivers aspire to as they envision their potential care in later life. It draws on data from a qualitative study exploring the significance of caregiving to adult daughters’ perspectives and plans for their own aging. Caregivers’ experiences differ based upon their perception of how easy or difficult it was to care for their loved one. The former exemplifies a positive way to approach aging and the receiving of care. Being easy describes an attitude that these caregivers desired for their own later life.     

Elderly parent health and the migration decisions of adult children: Evidence from rural China

Recent research has shown that participation in migrant labor markets has led to substantial increases in income for families in rural China. This article addresses the question of how participation is affected by elderly parent health. We find that younger adults are less likely to work as migrants when a parent is ill. Poor health of an elderly parent has less impact on the probability of employment as a migrant when an adult child has siblings who may be available to provide care. We also highlight the potential importance of including information on nonresident family members when studying how parent illness and elder care requirements influence the labor supply decisions of adult children.     

Caregiving and Care-Receiving:

Many aspects of aging are women's issues. Yet research on aging has, until recently, focussed little attention of gender differences in the experience of growing old. Older women are more likely than older men to be poor, widowed, living alone in poor health, receiving assistance from both formal and informal supports, as well as being institutionalized in long-term care facilities. This secondary analysis of data from the 1982 Survey of the Elderly in the Waterloo Region attempts to address a gap in our knowledge concerning gender differences in the giving and receiving of social support in later years. Gender differences in (1) need for social support, (2) turning to formal assistance, (3) amount of formal assistance used, and (4) amount of informal assistance received were examined using analysis of variance and logistic regression procedures. The profile of social support that emerged suggests both similarities and differences in the way elderly men and women experience the giving and receiving of social support. Older women in this sample were found to be disadvantaged in the areas of income, health, years lived alone, and loneliness, relative to older men. Low-income was related to formal service use for older women, but not for older     

Likelihood of African American Primary Caregivers and Care Recipients Receiving Assistance From Secondary Caregivers: A Rural-Urban Comparison

We examine rural-urban differences in reliance on secondary caregivers for African American female primary caregivers (250 rural, 242 urban) and their care recipients. Logistic regression was used to identify caregiver and care recipient characteristics significantly associated with the likelihood of having a secondary caregiver within rural and urban samples. Post hoc Wald chi-square tests were used to identify significant between-sample differences in regression coefficients. Secondary caregivers were more common in urban than rural contexts. Having a secondary caregiver was more strongly related to primary caregivers' poorer physical health and nonresidence with care recipients in rural than urban contexts. Findings suggest that policy initiatives, such as the National Family Caregivers Support Act and the cash and counseling model, may benefit rural and urban residents, particularly rural residents as the majority of them lacked secondary caregiver assistance.     

Care Arrangement Decisions for Frail Older Women: Quantitative and Qualitative Perspectives

ABSTRACT

This study uses both quantitative and qualitative methods to investigate how a range of care arrangement decisions for frail older unmarried women are made. Quantitative data from the 1989 National Long-Term Care Survey provides information concerning factors that predict the probability of five categories of care arrangements, including self only care, nursing home care, informal only care, formal only care, and a mix of formal and informal care. Qualitative interview data provides information on what occurs during care arrangement decision-making processes. Results are combined to explain the choice of care arrangements for a small sample of chronically disabled older unmarried women. Results show that need factors, such as age and disability, are strong predictors of the need for assistance. Family members played a central role in determining care arrangements and often helped an older woman to avoid an unwanted care arrangement. The use of a broad measure of impairment resulted in high levels of disability for the sample participants. Both disability status and care arrangements were transitory in nature.     

Care arrangement decisions for frail older women: quantitative and qualitative perspectives

This study uses both quantitative and qualitative methods to investigate how a range of care arrangement decisions for frail older unmarried women are made. Quantitative data from the 1989 National Long-Term Care Survey provides information concerning factors that predict the probability of five categories of care arrangements, including self only care, nursing home care, informal only care, formal only care, and a mix of formal and informal care. Qualitative interview data provides information on what occurs during care arrangement decision-making processes. Results are combined to explain the choice of care arrangements for a small sample of chronically disabled older unmarried women. Results show that need factors, such as age and disability, are strong predictors of the need for assistance. Family members played a central role in determining care arrangements and often helped an older woman to avoid an unwanted care arrangement. The use of a broad measure of impairment resulted in high levels of disability for the sample participants. Both disability status and care arrangements were transitory in nature.     

The Gendered Division of Labor in Parental Caretaking:

Public ideology dictates that families take responsibility for the care of their frail and vulnerable members. Women more than men are the unpaid, informal caregivers of family members. This gendered division of labor is examined by using the U.S. Survey of Income and Program Participation. Differences between metropolitan and nonmetropolitan sons' and daughters' parental caregiving activities are examined in order to contrast areas having more traditional, conventional or conservative values with those adopting more feminist values. Results show that in addition to daughters performing the vast majority of tasks, there is a difference between the types of care provided by metropolitan and nonmetropolitan daughters. Nonmetropolitan daughters tend to perform more caregiving tasks considered to be traditional "women's work" while metropolitan daughters perform significantly more tasks considered to be nontraditional for women. The fmdings suggest that providing care is due more to socialization to gender roles than to women's supposed natural or biological tendencies for "nurturing."     

Descriptive study of older adults encountered by crisis intervention team (CIT) law enforcement officers

Increasingly, older adults who experience a mental health crisis come to the attention of crisis intervention team (CIT) law enforcement officers. These encounters are due largely to a lack of local mental health care resources. With few options available, individuals call 911 for assistance when an older adult exhibits alarming behavior. This article provides a profile of older adults encountered by CIT officers, identifies the reasons for the 911 call for assistance, and finds what predictors are associated with outcomes of those encounters. We found that these older adults were mostly female, Caucasian, diagnosed with depression, and attempting or threatening suicide.     

Is There a Trade-off Between Parent Care and Self-care?

Caregiving for family members is often described as a 36-hour day. Previous literature has suggested that family caregivers have little time to attend to their own health needs, such as participating in leisure-time physical activity. Using data from the Health and Retirement Study, we analyze whether time-allocation decisions reflect a conflict between time devoted to informal care and time devoted to self-health promotion through physical activity. The empirical model is a system of four correlated equations, wherein the dependent variables are hours spent caregiving, frequency of moderate and vigorous physical activity, and hours spent in paid work. Results from joint estimation of the four equations indicate limited evidence of a competition between time spent in caregiving and frequency of physical activity. Parental factors that increase allocation of care time to parents do not comprehensively induce reductions in the frequency of any type of physical activity, or in hours of work, among either men or women.     

Returns on Lifetime Investments in Children in Egypt

Parental expectations about the companionship and assistance they will receive in later life from their children are key considerations in family formation decisions. We explore patterns of parents’ investment and the support and contact they receive from adult children in Egypt, where fertility is falling and sources of support at all life stages are in flux. Using data from a survey of older adults in Ismailia governorate, we consider parents’ past investments in childbearing, child survival, and children’s education and marriage, as well as recent assistance to adult children via housing, care for grandchildren, gifts, and money. The returns from children considered include economic assistance, instrumental support, and visits. Most parental investments are associated with frequent visits from children. The assistance children provide to parents is gendered: sons tend to provide economic transfers, whereas daughters tend to provide instrumental help. A greater number of surviving children is most strongly associated with parents’ receipt of multiple types of later-life returns. Investments in children’s education and marriage are not associated with assistance, but recent assistance to children—especially economic transfers and provision of housing—is associated with receiving instrumental assistance from adult children.     

The informal health sector and health care-seeking behaviour of mothers in urban Dhaka slums

Infant and child mortality in Bangladesh has declined in recent years but early death rates remain high among Bangladesh’s urban poor, even in comparison to rates in rural Bangladesh. Although they live close to the country’s leading public hospitals and private health clinics, the urban poor continue to rely heavily on services and advice provided by the informal health sector. This paper examines the use of the informal health sector by urban poor children’s main caregivers, their mothers, and the key role performed by pharmacists in treating these children. It explores the nature of the relationship between the mothers and the health providers and the implications for the broader health system. The study combines in-depth interviews with survey data.     

Caregiver stressors and depressive symptoms among older husbands and wives in the United States

Framed by Pearlin’s Stress Process Model, this study prospectively examines the effects of primary stress factors reflecting the duration, amount, and type of care on the depressive symptoms of spousal caregivers over a2-year period, and whether the effects of stressors differ between husbands and wives. Data are from the 2004 and 2006 waves of the Health and Retirement Study and we included community-dwelling respondents providing activities of daily life (ADL) and/or instrumental activities of daily life (IADL) help to their spouses/partners (N = 774). Results from multivariate regression models indicate that none of the primary stressors were associated with depressive symptoms. However, wives providing only personal care had significantly more depressive symptoms than wives providing only instrumental care, while husbands providing different types of care showed no such differences. To illuminate strategies for reducing the higher distress experienced by wife caregivers engaged in personal care assistance, further studies are needed incorporating couples’ relational dynamics and gendered experiences in personal care.