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Economic Stress Among Adult-Child Caregivers of the Oldest Old in China: The Importance of Contextual Factors

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Abstract

Guided by Pearlin’s stress process model, this study tested the association between parents’ care needs, caregivers’ structural context, and caregivers’ perception of economic stress in providing care for their parents. Multinomial probit regression was conducted with the cross-sectional data from 895 pairs of Chinese oldest-old parents and their adult-child caregivers. The results indicate that caregiver’s low income, and reporting “eldest son” status increased the likelihood of reporting higher levels of economic stress. Caregivers who lived in urban areas, had poor health, or were divorced, widowed or unmarried reported higher levels of economic stress. These findings indicate the need of research on low-income caregivers and the relationship between filial norms and caregiving experience. This study also implies the need for culturally congruent social services and policies designed to enhance the family’s ability to care for elders.

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References

  • Bilotta, C., Bergamaschini, L., Arienti, R., Spreafico, S., & Vergani, C. (2010). Caregiver burden as a short-term predictor of weight loss in older outpatients suffering from mild to moderate Alzheimer’s disease: a three months follow-up study. Aging & Mental Health, 14(4), 481–488.

    Article  Google Scholar 

  • Campion, E. W. (1994). The oldest old. The New England Journal of Medicine, 330(25), 1819–1820.

    Article  Google Scholar 

  • Chan, K. W., & Zhang, L. (1999). The hukou system and rural–urban migration in China: processes and changes. The China Quarterly, 160, 818–855.

    Article  Google Scholar 

  • Chen, F., & Liu, G. (2009). Population aging in China. In P. Uhlenberg (Ed.), International handbook of population aging (pp. 157–172). London: Springer.

    Chapter  Google Scholar 

  • Cheng, S.-T., & Chan, A. C. (2006). Filial piety and psychological well-being in well older Chinese. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61(5), 262–269.

    Article  Google Scholar 

  • Chernew, M. E., Hirth, R. A., Sonnad, S. S., Ermann, R., & Fendrick, A. M. (1998). Managed care, medical technology, and health care cost growth: a review of the evidence. Medical Care Research and Review, 55(3), 259–288.

    Article  Google Scholar 

  • Ci, Q. (2000). The analysis of the grander factor impacting the choice of family support. Population Journal, 120(2), 29–32 (in Chinese).

    Google Scholar 

  • Cooney, R. S., & Di, J. (1999). Primary family caregivers of impaired elderly in Shanghai, China: kin relationship and caregiver burden. Research on Aging, 21(6), 739–761.

    Article  Google Scholar 

  • Cutler, D. M., & Meara, E. (2001). The concentration of medical spending. In D. A. Wise (Ed.), Themes in the economics of aging (pp. 217–240). Chicago: University of Chicago Press.

    Chapter  Google Scholar 

  • Davis, A. J., Martinson, I., Lan, C. G., Jin, Q., Yi, H. L., Davis, D. B., et al. (1998). Informal caregivers for urban chronically ill elderly people at home in the People’s Republic of China: a qualitative study. Health Care in Later Life, 3(1), 3–14.

    Google Scholar 

  • Edwards, A. B., Zarit, S., Stephens, M., & Townsend, A. (2002). Employed family caregivers of cognitively impaired elderly: an examination of role strain and depressive symptoms. Aging & Mental Health, 6(1), 55–61.

    Article  Google Scholar 

  • Gaugler, J. E., Kane, R. A., & Langlois, J. (2000). Assessment of family caregivers of older adults. In R. L. Kane & R. A. Kane (Eds.), Assessing older persons: Measures, meaning and applications (pp. 320–359). New York: Oxford University Press.

    Google Scholar 

  • Goode, W. J. (1960). A theory of role strain. American Sociological Review, 25(4), 483–496.

    Article  Google Scholar 

  • Gu, D. (2008). General data quality assessment of the CLHLS. In Healthy longevity in China (pp. 39–60). Netherlands: Springer.

  • Gu, D., & Zeng, Y. (2004). Sociodemographic effects on the onset and recovery of ADL disability among Chinese oldest-old. Demographic Research, 11(1), 1–42.

    Google Scholar 

  • Gu, D., & Vlosky, D. A. (2008). Long-term care needs and related issues in China. In J. B. Garner & T. C. Christiansen (Eds.), Social sciences in health care and medicine (pp. 51–84). New York: Nova Publisher.

    Google Scholar 

  • Guo, Z. (1996). Factors affecting living arrangement of the Chinese elderly women. Population Research, 20(5), 45–53 (in Chinese).

    Google Scholar 

  • Heru, A. M., & Ryan, C. E. (2006). Family functioning in the caregivers of patients with dementia: one-year follow-up. Bulletin of the Menninger Clinic, 70(3), 222–231.

    Article  Google Scholar 

  • Heru, A. M., Ryan, C. E., & Iqbal, A. (2004). Family functioning in the caregivers of patients with dementia. International Journal of Geriatric Psychiatry, 19(6), 533–537.

    Article  Google Scholar 

  • Hsu, H.-C., & Shyu, Y.-I. L. (2003). Implicit exchanges in family caregiving for frail elders in Taiwan. Qualitative Health Research, 13(8), 1078–1093.

    Article  Google Scholar 

  • Ikels, C. (2004). Filial piety: Practice and discourse in contemporary East Asia. Standford: Stanford University Press.

  • Jiang, C., Gu, D., Liu, Y., & Zeng, Y. (2009). Research on the informal care cost among the Chinese elderly–application of the multi-state life table method. Population Research, 33(3), 81–88 (in Chinese).

    Google Scholar 

  • Kincannon, C., He, W., & West, L. (2005). Demography of aging in China and the United States and the economic well-being of their older populations. Journal of Cross-Cultural Gerontology, 20(3), 243–255.

    Article  Google Scholar 

  • Koyano, W. (1996). Filial piety and intergenerational solidarity in Japan. Australian Journal on Ageing, 15(2), 51–56.

    Article  Google Scholar 

  • Lea Steadman, P., Tremont, G., & Duncan Davis, J. (2007). Premorbid relationship satisfaction and caregiver burden in dementia caregivers. Journal of Geriatric Psychiatry and Neurology, 20(2), 115–119.

    Article  Google Scholar 

  • Lee, M., & Kolomer, S. (2007). Design of an assessment of caregivers’ impulsive feelings to commit elder abuse. Research on Social Work Practice, 17(6), 729–735.

    Article  Google Scholar 

  • Liang, H. (2000). Evaluation and analysis on rural social security system. Population Journal, 124(6), 26–31 (in Chinese).

    Google Scholar 

  • Liu, J., & Bern-Klug, M. (2011). Elders’ expectations of community health services in China. Indian Journal of Gerontology, 25(4), 532–552.

    Google Scholar 

  • Magai, C., & Cohen, C. I. (1998). Attachment style and emotion regulation in dementia patients and their relation to caregiver burden. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 53(3), 147–154.

    Article  Google Scholar 

  • Montgomery, R. J. V., Gonyea, J. G., & Hooyman, N. R. (1985). Caregiving and the experience of subjective and objective burden. Family Relations, 34(1), 19–26.

    Article  Google Scholar 

  • Moran, W. P., Lv, S., & Chen, J. G. (2008). Impairment and disability in the Chinese and American oldest-old population. In Y. Zeng, D. L. Poston, D. A. Vlosky, & D. Gu (Eds.), Healthy longevity in China: Demographic methods and population analysis (pp. 305–314). New York: Springer.

    Chapter  Google Scholar 

  • Mu, G., & Miao, J. (2002). Chinese social security system in retrospect and reference. Population Journal, 131(1), 30–38 (in Chinese).

    Google Scholar 

  • Patterson, T. L., Semple, S., Shaw, W., Yu, E., He, Y., Zhang, M., et al. (1998). The cultural context of caregiving: a comparison of Alzheimer’s caregivers in Shanghai, China and San Diego, California. Psychological Medicine, 28(5), 1071–1084.

    Article  Google Scholar 

  • Pearlin, L. I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30, 241–256.

    Article  Google Scholar 

  • Pearlin, L. I. (1999). The stress process revisited. In C. S. Aneshensel & J. C. Phelan (Eds.), Handbook of the sociology of mental health (pp. 395–415). New York: Kluwer Academic/Plenum Publishers.

    Google Scholar 

  • Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30(5), 583–594.

    Article  Google Scholar 

  • Peng, X., & Song, T. (2002). Survey of the rural social endowment insurance. Population Journal, 135(4), 43–47 (in Chinese).

    Google Scholar 

  • Poston, D. L., & Duan, C. C. (2000). The current and projected distribution of the elderly and eldercare in the People’s Republic of China. Journal of Family Issues, 21(6), 714–732.

    Article  Google Scholar 

  • Qiu, Y., & Li, S. (2008). Stroke: coping strategies and depression among Chinese caregivers of survivors during hospitalisation. Journal of Clinical Nursing, 17(12), 1563–1573.

    Article  Google Scholar 

  • Schulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality. JAMA, the Journal of the American Medical Association, 282(23), 2215–2219.

    Article  Google Scholar 

  • Sherwood, P. R., Given, C. W., Given, B. A., & von Eye, A. (2005). Caregiver burden and depressive symptoms: analysis of common outcomes in caregivers of elderly patients. Journal of Aging and Health, 17(2), 125–147.

    Article  Google Scholar 

  • Smith, J., Borchelt, M., Maier, H., & Jopp, D. (2002). Health and well–being in the young old and oldest old. Journal of Social Issues, 58(4), 715–732.

    Article  Google Scholar 

  • Spaid, W. M., & Barusch, A. (1994). Emotional closeness and caregiver burden in the marital relationship. Journal of Gerontological Social Work, 21(3–4), 197–212.

    Article  Google Scholar 

  • Tang, Y. (2006). Obligation of filial piety, adult child caregiver burden, received social support, and psychological wellbeing of adult child caregiversfor frail elderly people in Guangzhou, China. ProQuest Dissertations & Theses database (0819161).

  • Torrey, B. B. (1992). Sharing increasing costs on declining income: The visible dilemma of the invisible aged. In R. M. Suzman, D. P. Willis, & K. G. Manton (Eds.), The oldest old (pp. 381–393). New York: Oxford University Press.

    Google Scholar 

  • Turner, J. H. (1997). The institutional order. New York: Addison-Wesley Educational Publishers.

    Google Scholar 

  • United Nations, (2009). World population prospects: 2008 revision population database. Retrieved from http://esa.un.org/UNPP/.

  • Walker, A. J., Shin, H.-Y., & Bird, D. N. (1990). Perceptions of relationship change and caregiver satisfaction. Family Relations, 39, 147–152.

    Article  Google Scholar 

  • Wang, L., & Schneider, J. W. (1993). Home care for the chronically ill elderly in China: the family sickbed in Tianjin. Journal of Cross-Cultural Gerontology, 8(4), 331–348.

    Article  Google Scholar 

  • Wilson-Genderson, M., Pruchno, R. A., & Cartwright, F. P. (2009). Effects of caregiver burden and satisfaction on affect of older end-stage renal disease patients and their spouses. Psychology and Aging, 24(4), 955–967.

    Article  Google Scholar 

  • Youn, G., Knight, B. G., Jeong, H.-S., & Benton, D. (1999). Differences in familism values and caregiving outcomes among Korean, Korean American, and White American dementia caregivers. Psychology and Aging, 14(3), 355–364.

    Article  Google Scholar 

  • Yue, X., & Ng, S. H. (1999). Filial obligations and expectations in China: current views from young and old people in Beijing. Asian Journal of Social Psychology, 2(2), 215–226.

    Article  Google Scholar 

  • Zeng, Y., Vaupel, J. W., Xiao, Z., Zhang, C., & Liu, Y. (2002). Sociodemographic and health profiles of the oldest old in China. Population and Development Review, 28(2), 251–273.

    Article  Google Scholar 

  • Zhan, H. J. (2005). Social-economic context of parent care: explaining Chinese caregivers’ psychological and emotional well-being. Journal of Gerontological Social Work, 45(4), 83–100.

    Article  Google Scholar 

  • Zhang, F. Q. (2004). Economic transition and new patterns of parent‐adult child coresidence in Urban China. Journal of Marriage and Family, 66(5), 1231–1245.

    Google Scholar 

  • Zhang, Z. (2008). The effects of adult children’s caregiving on the health status of their elderly parents: Protection or selection? In Y. Zeng, D. L. Poston, D. A. Vlosky, & D. Gu (Eds.), Healthy Longevity in China: Demographic methods and population analysis (pp. 251–268). New York: Springer.

    Chapter  Google Scholar 

  • Zhu, Y. (2002). Recent developments in China’s social security reforms. International Social Security Review, 55(4), 39–54.

    Article  Google Scholar 

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Authors and Affiliations

  1. School of Social Work, University of Michigan, Room 3753, 1080 S. University Ave., Ann Arbor, MI, 48109, USA

    Jinyu Liu

  2. School of Social Work, The University of Iowa, Room 308 North Hall, Iowa City, IA, 52242, USA

    Man Guo & Mercedes Bern-Klug

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  1. Jinyu Liu
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Correspondence to Jinyu Liu.

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Liu, J., Guo, M. & Bern-Klug, M. Economic Stress Among Adult-Child Caregivers of the Oldest Old in China: The Importance of Contextual Factors. J Cross Cult Gerontol 28, 465–479 (2013). https://doi.org/10.1007/s10823-013-9216-3

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