Page 45 - IJPS-11-5

International Journal of
Population Studies Need for social services among disabled older Chinese

Traditionally, Chinese older adults rely primarily on With the growing need for care and the declining
family members for care and support (Xie & Zhu, 2009; availability of family caregivers, the demand for non-family
Zhu & Xie, 2017). This practice is based on the Confucian services is increasing (Feng et al., 2020). Hence, while filial
norm of filial piety, which has long been a core societal piety is still accepted by younger generations and promoted
value and is even written into the Law for Protecting Older by the Chinese government, policymakers are under
Persons and into the Constitution (Gu & Vlosky, 2008; pressure to develop formal care systems to complement
Zou et al., 2024). According to this norm, family members, family care and construct a more sustainable LTC system
particularly adult children, are obligated to provide care (Du, 2013; Lai & Yang, 2021). Among the various types of
and support to old family members, including both formal care service programs, community-based services,
financial assistance and personal care (Lai & Yang, 2021). and especially home-based services, are preferred by most
Because filial piety is so deeply rooted in society, families Chinese older adults and thus promoted by the government
may be reluctant to place their older members in a social (Feng et al., 2012; 2020; Liu et al., 2015). These services are
or commercial care unit (Feng et al., 2012). However, particularly relevant to the objectives of “aging in place”
the sustainability of this traditional practice is facing (Cesari et al., 2022) and “aging in the right place” (Golant,
challenges. Dramatic demographic, social, and economic 2015; Hoh et al., 2021) that the Chinese government has
changes over the last several decades have weakened both prioritized since the mid-2010s (Jia et al., 2020; Krings
the ability and willingness of family members to provide et al., 2022). Studies have shown that older adults prefer
care to older adults (Feng et al., 2012; Lai & Yang, 2021; to remain in their homes as they age (Hoh et al., 2021;
Leung, 1997). For instance, while women have traditionally Means, 2007). A central meaning of “aging in the right
been family caregivers, those aged 40 – 59 in China are now place” is to ensure older adults receive the right services
increasingly active in the labor force. In 2020, the labor at the right time by the right provider(s) at the right place
force participation rate in each 5-year age group was 5 – (Hoh et al., 2021). In addition, aligning service provision
10% points higher than in 2010 (Feng, 2022). Meanwhile, with the specific needs of older adults facilitates meeting
increased geographic mobility further limits the availability user needs and optimizing resources (Iglesias Souto et al.,
of potential family caregivers (Feng et al., 2012; 2020), 2021). Therefore, to inform government policy initiatives
especially the pattern of rural residents migrating to cities to improve the old-age care system and reduce family
for better job opportunities. The combination of all these burden, it is crucial to understand the need for social
changes over time contributes to the declining level of services among older adults in China. This understanding
family support for older adults in China. will enable better services to effectively support “aging in
Another challenge to meeting older adults’ care needs the right place.”
is China’s underdeveloped system of formal, non-family To date, research on the need for social services in China
sources for old-age care (Feng et al., 2020). Non-family remains limited. Most research focused on the availability
care includes but is not limited to institutional care, home- and utilization of formal care (e.g., Li et al., 2017; Wu
based care, and community-based care. Institutional care et al., 2005). Among the few studies that addressed the
has been mostly restricted to the “Three Nos,” (i.e., older need for formal care in China, Liu et al. (2014) found that
adults with no children, no income, and no relatives) as age, education, social support, and chronic diseases were
a public welfare system (Gu & Chu, 2021; Leung, 1997; associated with home health-care needs for empty-nest
Yang et al., 2016), or to those who need care and can afford older adults in Shanghai. Liu et al. (2015) also conducted a
the high cost of services (Gu et al., 2007). However, the qualitative study among empty-nest older adults in Beijing
rate of institutionalized care is still very low, at only about and reported that their major need was home-based care.
1.5 – 2.0% of people aged 65 and older in 2010 (Feng Another study by Li et al. (2017) found that urban Chinese
et al., 2020; Gu & Chu, 2021). Home- and community- older adults’ need for social services, including medical
based care such as the service-reserve project, the friends care and rehabilitation, instrumental care and support,
and neighborhood mutual help project, service centers and psychosocial services, varied by ADL/Instrumental
for older adults, and daycare centers emerged in the ADL, depression, financial status, and support network.
1990s (Shanghai Civil Affairs, 2002). By 2023, there were Zhou & Walker (2015) analyzed national data in 2008 and
363,000 community-based old-age care service centers and also found that older adults’ need for community services
facilities, including 41,000 full-time care centers (Ministry varied. For instance, higher educational attainment has
of Civil Affairs of China, 2024). However, these services been linked to a reduced need for social services, whereas
still remain limited except in a few large cities due to high higher economic status has been associated with a greater
costs, lack of skilled professionals, and policies favoring demand for these services. A recent study by Xiao et al.
urban areas (Feng et al., 2020). (2023) examined the preferences for social services

Volume 11 Issue 5 (2025) 39 https://doi.org/10.36922/ijps.448