Preparation for future care needs among parents of only children in urban China

Abstract

Older persons need increasing assistance with daily activities as they age. The need for care may be sudden (e.g., because of a stroke) and may overwhelm both the senior and his or her family. Though adult children have traditionally been the primary caregivers of older parents in China, modernization and the one-child policy (1979–2015) have weakened their willingness and capacity to provide care. Though the Chinese government has endeavored to develop the elder care system, long-term care services are characterized by acute shortages and low quality. Under such conditions, it may help ensure care by informed caregivers if parents of only children have made preparations for care beforehand. The current study was designed to answer three questions. First, what are the current planning status, general planning patterns, and predictors of preparation for future care among Chinese parents of only children? Second, what are the differences between viewing preparation for future care needs as a process and as a temporary expectation? Third, what are the associations between family constructs (support exchange, filial obligation, and intergenerational relationships) and preparation for future care? To answer these questions, a two-phase study was conducted. Phase 1 adapted measurement of preparation for future care with a forward-backward translation procedure and pilot tests supervised by a panel of experts. In Phase 2, 580 participants ages 45 to 65 from 11 districts in Shanghai completed a one-time survey. Results indicated that parents of only children in urban China were active in preparing for future care. The associations between viewing care preparation as a process and a care expectation varied with the focus of the expected care. Family plays an important role in care preparation but may not always facilitate preparation. The current study complements the existing literature by combining theories in family studies and with proactive coping theory. It is the first study on preparation for future care conducted in an Asian context. It contributes to the indigenous research on long-term care not only by providing a handy Chinese care preparation questionnaire but also by providing information for further setup of interventions based on planning predictors. Limitations are discussed, along with limitations and implications in terms of theory, research, and intervention. (364 words)