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Worry about eldercare in China

and Alexander, 1995). Living arrangements have become a result of each generation’s needs, economic resources, health,
and ability to provide (Asis, Domingo, Knodel et al., 1995). While coresidence with children was found to be beneficial
to the psychological well-being of the widowed Chinese older adults, it did not make any difference for those who
were married (Wang, Chen, and Han, 2014). Another study found that the daily maintenance dimension of filial piety,
which includes the frequency of contact and assistance with daily activities, was not associated with life satisfaction or
psychological well-being of Chinese older adults (Cheng and Chan, 2006). Following these findings, we hypothesize
that the association of family relations, measured by the number of children, coresidence with at least one adult child,
and children’s filial piety, with older adults’ worry about eldercare may become less significant from 2000 to 2010, when
older adults’ socio-economic resources and the availability of community services are taken into account (Hypothesis 2a).
On the other hand, it was found that even with dramatic economic development in recent decades, family-based
care is still the backbone of care provision for older adults in China (Shen and Yeatts, 2013; Zavoretti, 2006). Families
have been the bedrock of providing care to older adults in China and many Asian societies. The Confucian value of filial
piety, where the younger generation is expected to respect and take care of their elderly parents, has been instilled for
generations (Chow, 2004; Zhang and Yeung, 2012). “More children, more happiness” has been the conventional wisdom.
Living with at least one married son has been the ideal living arrangement. Even though NRSP has improved the quality
of life for many Chinese older adults in rural areas, the impact of family structure, such as the number of children, remains
significant (Liu, Han, Xiao et al., 2015). Thus, the crucial role played by families, especially adult children, may not
simply fade away as alternative options of care are available for at least two underlying reasons.
First, children are thought to provide better care than nonfamily caregivers. They know better the needs and habits
of older adults, thus able to provide better care (Chen, 2002). In one study in Hong Kong, Chinese older adults gave
a detailed account of the advantages of living with adult children (Ng, Phillips, and Lee, 2002). Living with children
provided a sense of security. They felt happy and safe. They could count on getting help immediately once an emergency
came up. Children gave the best emotional support.
The second reason may be tied to the strong value and practice of filial piety, which has been instilled in the collective
consciousness. Adult children’s provision of care for their parents does not only serve a practical function – meeting
parents’ material or other needs but it is also a manifestation of filial piety and moral obligation on the part of children.
It is a symbol of adult children’s appreciation and repayment of care and love received early in life from parents (Asis,
Domingo, Knodel et al., 1995). The absence of such an act makes both parents and children “lose face,” even though
parents’ needs may be met by other sources, such as paid workers or institutions. One qualitative study in Thailand is a
case in point. Even though coresidence with children has declined, 80% of the respondents from a national survey in 2011
still regarded it as the most appropriate living arrangement, regardless of the respondent’s age. About two-thirds of the
respondents agreed that children should be the main provider of care for older adults. Children were viewed as the ideal
personal care providers. Concern about having an outside person to fulfill such an intimate role was still common. While
paid caregivers were acceptable when children were working or serving as children’s assistant, full-time services that
replaced care from children were viewed less favorably. As one respondent said, “No matter who will be caregiver they
are not children,” followed by another, “I don’t think a paid caregiver can substitute for children for giving care to parents”
(Knodel, 2012, p. 20). In Japan, family-based care is still central to eldercare in spite of the introduction of long-term care
insurance scheme in 2000 (Kawakami and Son, 2015). Even in Spain, there is a strong intergenerational solidarity. Informal
support provided by family members is pre-eminent in its culture. Taking care of older adults by younger generations
is an expected duty rather than an option (Fernandez-Carro, 2016). Therefore, we develop an alternative hypothesis to
Hypothesis 2a: The association of family relations with older adults’ worry about eldercare remains significant in both
years even when older adults’ socioeconomic resources and the availability of community services are taken into account
(Hypothesis 2b).
2. Data and Methods

2.1. Study Population
We will use the survey on aged population in urban/rural China to describe the general trend of eldercare in China
and test the research hypotheses. The survey is conducted by China Research Center on Aging, which is a consulting
branch of China National Committee on Aging. All survey procedures meet the ethical standard of the committee. So
far, four waves of data have been collected in 2000, 2006, 2010, and 2016, respectively, whereas the data from the most
recent wave are currently unavailable. The survey covers all geographical regions: North, Northeast, East, Southcentral,

4 International Journal of Population Studies | 2019, Volume 5, Issue 2