The Effects of Familism on Intended Care Arrangements in the Process of Preparing for Future Care

Background:The escalating care needs of the older population will strain both individual families and social care system. Modernization has weakened family capacity and willingness to take care of the elders. Even when the family is willing, they may not have the necessary resources to provide such care. Sole reliance on family for elder care is no longer a realistic option. Moving to institutions is costly and also undesired for most older persons. To facilitate better resource management on the community level and to inform policymakers and service providers on future care needs, it is important that we understand people’s intensions of future care arrangements.

Although care services allow older persons to maintain independence, it is underused in population who has a strong belief in familism. The paper therefore aimed to investigate the impacts of familism on intended care arrangements using the model of preparation for future care needs.

Methods:Data was collected from 516 one-child’s parents residing in Shanghai using a quota sampling strategy in 2013. Respondents’ age ranged from 45 to 65 (Mean=54.90, SD=5.41). Both genders were equally represented (males = 49.8%; females = 50.2%). Five ordinal logistic regression models were analyzed to exam the impacts of familism (filial obligation and child gender) and planning behaviors (awareness and information gathering) on five intended care arrangements when demographic characteristics were controlled for.

Results:The most favored arrangements were remaining at home with the aid of family (43%) and community service (30%), followed successively by moving to institutions, hiring domestic helper and relying on child. The arrangements of using community service and institutions were positively associated with awareness and information gathering. Relying on child was more prevalent among participants avoidant of planning. Participants with stronger filial obligation placed greater expectations on ageing-at-home with the aid of family and helper. Child gender did not indicate intended care arrangement preferences.

Implications: The model of preparation for future care needs was useful in predicting service-focused care arrangements in familism cultures. However, only avoidance was indicative of a certain type of family-focused care arrangements. Researchers may consider the nature of the expected care arrangements before applying the model in familism-adherent populations. Familism increased the likelihood of family-focused care arrangements. Its impacts were stronger on females. Their preferences for care by child implied that the insignificant association between child gender and care arrangement was not due to lowered expectations for sons but heightened expectations for daughters. Females’ reluctance to rely on husbands for care indicated that modernization hadn’t shifted the emphasis of elder care at home from patrilineal to conjugal bonds in familism cultures. Policy makers and services providers may bear these culture habits in mind when developing community schemes to help elders age in place.