scholarly journals Utilisation willingness for institutional care by the elderly: a comparative study of empty nesters and non-empty nesters in Shandong, China

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e022324 ◽  
Author(s):  
Yangyang Qian ◽  
Wen Qin ◽  
Chengchao Zhou ◽  
Dandan Ge ◽  
Li Zhang ◽  
...  
Keyword(s):  
Rural Areas ◽  
Living Arrangements ◽  
Urban Areas ◽  
Institutional Care ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Empty Nest ◽  
Care Needs ◽  
Term Care ◽  
The Government

IntroductionInstitutional care has been strongly promoted in China to meet seniors’ long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors.MethodsA total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters.ResultsOur study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters.ConclusionsThe government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.

Willingness to live in eldercare institutions among older adults in urban and rural China: a nationwide study

2009 ◽  
Vol 30 (4) ◽  
pp. 583-608 ◽  
Author(s):  
RITA JING-ANN CHOU
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Filial Piety ◽  
Long Term Care ◽  
Cultural Beliefs ◽  
Institutional Care ◽  
Policy Implications ◽  
Care Needs ◽  
Term Care

ABSTRACTRecent economic development and socio-cultural changes have made it increasingly difficult for Chinese families to provide eldercare. Consequently, institutional care has been strongly promoted to meet older adults' long-term care needs. Although it has been estimated that China needs more beds to meet such needs, unfilled beds have been reported nationwide. One reason for the low occupancy may be a lack of willingness among older adults to live in long-term care institutions. Based on a national survey of 20,255 older adults, this study examined the extent of willingness among older Chinese to live in eldercare institutions, and it was found that in urban and rural areas, only 20 and 17 per cent of older adults, respectively, were willing to do so. Using an integrated theoretical model and logistic regression analyses, this study shows that gender, perceived family harmony, perceived filial piety, socio-cultural beliefs and practices about raising children and eldercare, knowledge and opinion about eldercare institutions, and self-assessed economic status were associated with willingness to live in eldercare institutions for both urban and rural older adults, while other predictors of willingness had different effects. The paper concludes with a discussion of the substantive, theoretical and policy implications for long-term care in China.

scholarly journals Prediction of the Number of and Care Costs for Disabled Elderly from 2020 to 2050: A Comparison between Urban and Rural Areas in China

2020 ◽  
Vol 12 (7) ◽  
pp. 2598 ◽  
Author(s):  
Liangwen Zhang ◽  
Sijia Fu ◽  
Ya Fang
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Severe Disabilities ◽  
Term Care ◽  
The Sustainable Development ◽  
Global Challenge ◽  
Disabled Elderly ◽  
Urban And Rural Areas ◽  
Care Costs

An aging population and an increase in the proportion of elderly people who are disabled have created an unprecedented global challenge, especially in China. This study aimed to predict the number of, and the care costs for, disabled elderly from 2020 to 2050 in China. A comparison was made between urban and rural areas, and we analyzed what must be done to maintain the sustainable development of China’s long-term care insurance (LTCI) system. An overall simulation model and a Monte Carlo simulation were used to estimate the number of disabled elderly and their related care costs, in both urban and rural areas. According to the forecast, the total disabled population will increase rapidly, rising from 43.75 million in 2020 to 91.4 million in 2050. Of that total, 69.7% are expected to be urban elderly. Starting in 2020, the growth rates of the elderly with mild, moderate, and severe disabilities will be 108%, 104%, and 120%, respectively, by 2050. Accordingly, the total care costs will increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050, of which 80.2% will be required in urban areas. In addition, the per capita costs of care in urban and rural areas in 2050 will be 6 times and 11 times higher than in 2020, respectively. The predicted results show that the number of disabled elderly and the related care costs will increase sharply from 2020 to 2050, especially the growth rate of the number of severely disabled elderly. This study provides strong evidence of the need for the establishment of a unified national LTCI system in China.

scholarly journals Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Pattaraporn Khongboon ◽  
Sathirakorn Pongpanich
Keyword(s):  
Informal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Socioeconomic Development ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Rural And Urban Areas ◽  
Rural And Urban

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

scholarly journals Mask Using Practice among Bangladeshi Population During COVID-19 Pandemic: A Video-Based Observational Study

2021 ◽  
Vol 4 (4) ◽  
Author(s):  
Chowdhury Farheen ◽  
◽  
Md Maruf Haque Khan ◽  
Muhammad Ibrahim Ibne Towhid ◽  
Sabrina Mousum ◽  
...  
Keyword(s):  
Public Transportation ◽  
Rural Areas ◽  
Urban Areas ◽  
Vaccination Campaign ◽  
Binary Logistic Regression ◽  
P Value ◽  
Public Places ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
The Government

Background: Although the government of Bangladesh made the use of masks mandatory in public settings during COVID-19, individuals have been reluctant to follow. We intended to know how many people used face masks in public settings during COVID-19. Methodology: This study was conducted in several public settings in Shahbag, an urban sub-district of Dhaka; and Sirajdikhan, a rural sub-district of Munshiganj in Bangladesh on November 2020. A total of 4011 people were identified from the video-graphic data captured from 20 public places for monitoring the use of masks. Finding: More than two-thirds of those observed had no face masks or did not utilize them properly. People in urban regions (43%) used mask more in an appropriate manner than those in rural areas (26%). Females wore masks comparatively more than males (53% vs. 35%, p-value <0.001). People used masks more in the morning than in the afternoon (39% vs. 34%, p-value <0.001). People were seen to use a mask more in hospital areas (60%) than in other places. However, in public transportation stands only one-fourth (25%) of the people wore a mask in an appropriate manner. In binary logistic regression male sex, rural area, public places and time of observation (afternoon) were found as risk factors for not wearing a mask. Interpretation: The general population of both rural and urban areas of Bangladesh is reluctant to wear face masks. Along with the ongoing vaccination campaign, people of Bangladesh need to wear masks for the prevention of COVID-19. Funding: This research has been partially supported by Bangabandhu Sheikh Mujib Medical University.

scholarly journals PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S847-S847
Author(s):  
liangwen zhang ◽  
Ya Fang
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Urban Areas ◽  
Census Data ◽  
The Elderly ◽  
Severe Disabilities ◽  
Term Care ◽  
Total Care ◽  
Urban And Rural Areas ◽  
Care Costs

Abstract Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.

scholarly journals Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China

2020 ◽  
Vol 17 (5) ◽  
pp. 1701
Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Lixia Wang ◽  
Ya Fang
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Influential Factors ◽  
Term Care ◽  
Home Based ◽  
Urban Rural ◽  
Young Old

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

scholarly journals CHARACTERISTICS AND LIVING ARRANGEMENTS OF CHILDLESS ELDERLY AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S253-S254
Author(s):  
Xiao Xu ◽  
Jersey Liang ◽  
BoRin Kim ◽  
Mary Beth Ofstedal ◽  
James Raymo
Keyword(s):  
Living Arrangements ◽  
College Education ◽  
The Elderly ◽  
Care Needs ◽  
Term Care ◽  
Biological Children ◽  
Nationally Representative ◽  
Cognitively Intact ◽  
Complex Sample Design

Abstract Despite a growing number of Americans without children, information on characteristics of childless older adults and their living arrangements is sparse and often outdated. To address this knowledge gap, we examined data from the 2014 Health and Retirement Study (HRS) on childless Americans age ≥65 years (N=760) and compared with childless elders in 2004 HRS (N=830). All analyses accounted for complex sample design of HRS to generate nationally representative estimates. The proportion of elderly Americans without any living biological or step children increased from 8.1% in 2004 to 9.4% in 2014. Compared to childless elders in 2004, those in 2014 were younger (mean age=76.8 years versus 73.8 years, p&lt;0.01) with a higher proportion completing college education (20.7% versus 37.5%, p&lt;0.01) or were cognitively intact (64.6% versus 73.6%, p&lt;0.01). However, childless elders in 2014 had more chronic conditions than those in 2004 (mean=2.5 versus 2.3, p&lt;0.01). The proportion of childless elders living independently (alone or with a spouse) (81.6% in 2004 versus 82.6% in 2014) or living with others (10.0% in 2004 versus 13.5% in 2014) remained relatively stable, whereas the proportion living in nursing homes declined significantly from 8.4% in 2004 to 4.0% in 2014 (adjusted odds ratio [OR]=0.07, p&lt;0.01). A sensitivity analysis limited to childless elders without biological children showed that they accounted for 9.9% of the elderly population in 2004 versus 11.9% in 2014, while other results were generally similar. These findings can help inform long term care needs of childless elders.

scholarly journals Development dynamics of health and social infrastructure for the long-term care – The case of the Posavje region

2021 ◽  
Vol 60 (4) ◽  
pp. 269-277
Author(s):  
David Bogataj ◽  
Marija Bogataj ◽  
Marta Kavšek
Keyword(s):  
Human Resources ◽  
Assisted Living ◽  
Rural Areas ◽  
Long Term Care ◽  
Housing Stock ◽  
Institutional Care ◽  
Social Infrastructure ◽  
Care Needs ◽  
Term Care

Abstract Background and purpose The populations of rural areas across Europe, especially Slovenia, are ageing rapidly and the areas themselves are becoming depopulated. Therefore, this study aims to contribute to our understanding of the population dynamics and provide a method for forecasting housing and other long-term care needs. Method The surveys questioned those responsible for long-term care, the caretakers in institutional care, and current and potential homecare users in rural areas of Slovenia. We wanted to discover what they considered as crucial in the process of long-term care deinstitutionalization. Our 2020–2050 projections are based on the surveys conducted across 38 municipalities in the Eastern Slovenian region and an in-depth empirical study in Posavje. The results are embedded in the demographic projections and the multistate transition model of the declining functional capacities to forecast the needed housing facilities and human resources. Results The results are the time series of required capacities. Around 60% of respondents in Slovenian rural areas believe that even a better organization of homecare would not allow them to stay at home until death due to inadequately built housing and the absence of a continuous presence of caregivers. These findings were included in the projections. Therefore, community care in the network of Smart Silver Villages was proposed. Discussion Investments are needed to renovate the housing stock of older adults and construct sheltered, assisted living housing and specialized households in the community. Moreover, proper education and training of human resources would increase the output. In addition, financial solutions are advised to develop Smart Silver Villages.

scholarly journals PSYCHOLOGICAL PROBLEMS AMONG RETIRED PEOPLE

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Mrs. Rajwant Kaur kaur ◽  
Dr. Krishna Chauhan chauhan
Keyword(s):  
Social Services ◽  
Rural Areas ◽  
Major Change ◽  
The Elderly ◽  
Psychological Problems ◽  
Daily Routine ◽  
Retirement Plans ◽  
Care Needs ◽  
Term Care ◽  
Community Activities

Many people experience loneliness and psychological problems in old age, either as a result of living alone or due to lack of close family ties and reduced connections with their culture of origin, which results in an inability to actively participate in the community activities. It has been documented that elderly are more prone to psychological problems and depression is the commonest geriatric psychiatric disorders. In fact the elderly in India face a multitude of psychological, social, and physical health problems. Although work practices are becoming increasingly diverse and flexible, with far fewer people staying in a single job for thirty or forty years, still there are many men retiring today who have been working in one role for many years. For these men, who have not experienced much variation in their daily routine for a long time, such a major change of lifestyle is often very stressful. Although they are more likely to own their homes, those dwellings are more likely to be substandard. They are more likely to be in poorer health than their urban counterparts. Yet, their health and long-term care needs are less likely to be met owing to problems in the availability of health and social services and the obstacles to delivering services in rural areas, including low population densities, limited transportation, and longer travel distances. No one can avoid and escape aging, but most individuals can opt to age productively. Retirement plans and policies should be enabling, allowing executives to address the new adjustments they need to adopt when counting down to retirement.

scholarly journals Age-Friendly Communities: Creating a conducive environment for the elderly in India

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Sameen Rafi ◽  
Shyna Saif
Keyword(s):  
Older People ◽  
Living Arrangements ◽  
Urban Areas ◽  
The Elderly ◽  
Urban Life ◽  
World Health ◽  
Indian Government ◽  
The World ◽  
The Government ◽  
Health Organization

India is one of the nations in the world where the population is undergoing anomalous demographic changes. The increase in longevity and decrease fertility lead to the boom of older people aged 60 and above both in relative and absolute terms. Due to the rise in number, it creates pressure not only on the family but the responsibility shifts to the government also. This issue becomes a significant social problem not only in India but across the globe. The government had taken action by creating policies and programs to provide services to them. Still, the majority of the elderly population is lacking behind in these areas like health facilities, infrastructure, living arrangements suffering from isolation, loneliness, abuse, crime. Nowadays, smart city initiatives are taken by the government across the country but still in process. To involve and facilitate more cities for "age-friendly," the World Health Organization develop the Global Age-Friendly Cities Guide and a manual "Checklist of Essential Features of Age-Friendly Cities." Cooperating with 35 urban communities from developed and developing nations, the WHO oversees eight highlights for age-accommodating urban areas in the space of urban life. This paper had an objective to study and understand exiting literature on age-friendly communities in developed and developing countries and draw attention to the need to create age-friendly cities in India. The realization of the needs and demands of older people, the Indian government should give attention to promote and implement more age-friendly communities all over the country. This initiative till now taken in 3 states, i.e., Delhi, Udaipur, and Kolkata-which involved in age-friendly community initiatives collaborated with WHO.  In this era of a rapid aging sphere, the communities have to enhance in such a manner where the older population can meet their needs quickly without any conflicts and problem. To conclude, the government and policymaker should emphasize the policies into practices to build age-friendly communities across the country and make better living conditions for "all-ages." For timely action and productive recommendation, it is an urgent need on the part of the government, policymakers, researchers, social workers to develop and enhance the community's facilities, which can gain confidence and wellbeing of the elderly in India

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