scholarly journals Childhood Adversities and Unmet Needs of Older Chinese Adults: The Mediation Effects of Family Relationships

2021 ◽  
pp. 016402752110482
Author(s):  
Bo Hu ◽  
Mingyu Wei

Ensuring equality and adequacy of care for older adults is vitally important. This study investigates the relationships between childhood adversities and unmet long-term care needs of older adults in China and the mediation effects of family relationships. The data came from a nationally representative sample of older Chinese adults aged 60 and over with long-term care needs ( N = 2186). We conducted mediation analyses and decomposed the total effects of childhood adversities on unmet needs into direct and indirect effects. The probability of unmet needs is significantly higher among older adults experiencing childhood adversities. Satisfaction with marriage mediates the association between childhood adversities and unmet personal care needs. Relationships with children mediate the association between childhood adversities and unmet domestic care needs. The causes of unmet needs can be traced back to early life, which underscores the importance of concerted efforts in family, education and long-term care policies to tackle unmet needs.

Author(s):  
Sunhee Park ◽  
Heejung Kim ◽  
Chang Gi Park

Abstract Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one’s community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.


2020 ◽  
pp. 073346482094306
Author(s):  
Vanessa Ramirez-Zohfeld ◽  
Anne Seltzer ◽  
Ana Ramirez ◽  
Ruqayyah Muhammad ◽  
Lee A. Lindquist

Many older adults wish to age-in-place but do not have long-term care plans for when they may require more assistance. PlanYourLifespan.org (PYL) is an evidence-based tool that helps older adults understand and plan for their long-term care needs. We examined the long-term effects of PYL use on user perceptions and planning of long-term care services. Individuals who previously accessed PYL were invited to complete an online, nation-wide mixed methodology survey about end-user outcomes related to PYL. Among 115 completed surveys, users found PYL helpful with long-term planning for their future needs. Over half of website users reported having conversations with others because of PYL use. However, 40% of respondents reported not having a conversation with others about their plans; common themes for barriers to planning included procrastination and a lack of immediate support needs. Although PYL helps with planning, many people are still not communicating their long-term care plans.


2016 ◽  
Vol 11 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Tomoko Wakui ◽  
Emily M. Agree ◽  
Tami Saito ◽  
Ichiro Kai

AbstractObjectiveIn the 2011 Great East Japan Earthquake, as in Hurricanes Katrina and Rita in the United States, older individuals were at the greatest risk of mortality. Much concern has been raised about developing plans to reduce these risks, but little information has been provided about preparedness, and the key role played by caregivers has been largely unexplored. The aims of this study were thus to examine the preparedness of family caregivers of older adults with long-term care needs and to identify the characteristics of older adults and their caregivers that are associated with poor preparedness and greater concern about disasters.MethodsShortly after the Great East Japan Earthquake, the second wave of the Fukui Longitudinal Caregiver Study was administered to the family caregivers of older Japanese individuals with long-term care needs. The sample included 952 caregivers from 17 municipalities in Fukui prefecture. Logistic regression analyses were used to identify the factors associated with self-assessed preparedness, evacuation planning, and caregivers’ concerns about preparedness.ResultsThe majority (75%) of the caregivers had no concrete plans for evacuation in an emergency, and those caring for persons with dementia were 36% less likely to have any plan. In multivariate models, caregivers who were more experienced and wealthier and who reported more family and community support were more likely to feel well prepared. Caregivers with poor health or limited financial resources or who were responsible for older persons with mobility difficulties reported higher levels of anxiety about their disaster preparedness.ConclusionsThis study indicates that most caregivers are ill prepared to respond in emergencies and that caregiver resources, community support, and the needs of older care recipients influence both preparedness and concern about disasters. Education for caregivers and the development of community support programs could provide important sources of assistance to this vulnerable group. (Disaster Med Public Health Preparedness. 2017;11:31–38)


2009 ◽  
Vol 30 (4) ◽  
pp. 583-608 ◽  
Author(s):  
RITA JING-ANN CHOU

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.


Author(s):  
Harriet L. Komisar ◽  
Judith Feder ◽  
Judith D. Kasper

People who are dually eligible for Medicare and Medicaid are the focus of fiscal struggles between federal and state governments. Drawing on a survey of community-based elderly “dual eligibles,” this paper examines how well their medical and long-term care needs are being met under the current combination of Medicare and Medicaid policies. While few people report difficulty getting medical care, 58% of people needing long-term care (help with activities of daily living) report unmet needs. As a result, many experience serious consequences, such as falls. Although unmet needs are substantial in all six states surveyed, we find the greater the use of paid home care in a state, the lower the likelihood of unmet needs, suggesting states' policies can make a difference.


2019 ◽  
pp. 1-20 ◽  
Author(s):  
Wei Yang ◽  
Si Ying Tan

Abstract Rapid demographic shifts and socio-economic changes are fuelling concerns over the inadequate supply of informal care – the most common source of care-giving for older people in China. Unmet long-term care needs, which are believed to cause numerous adverse effects on health, continue to increase. Drawing data from the 2015 wave of the China Health and Retirement Longitudinal Survey, this study explores the relationship between informal care provision and unmet long-term care needs among older people in China. We first examine the availability of informal care among older people with disabilities. We then analyse whether a higher intensity of informal care leads to lower unmet needs. Our findings suggest that the majority of older people with disabilities receive a low intensity of care, i.e. less than 80 hours per month. Besides, a higher intensity of informal care received could significantly lower the probabilities of unmet needs for the disabled older adults who have mainly instrumental activities of daily living limitations. Our study points out that informal care cannot address the needs of those who are struggling with multi-dimensional difficulties in their daily living. Our findings highlight a pressing need for the government to buttress the formal care provision and delivery systems to support both informal care-givers and disabled older people in China.


2019 ◽  
Vol 28 (9) ◽  
pp. 552-557 ◽  
Author(s):  
Fiona Kelly ◽  
Mary Reidy ◽  
Suzanne Denieffe ◽  
Catherine Madden

Background: person-centred care should be responsive to the needs of older adults in long-term care. It is central to collaborative and high-quality healthcare delivery. Aim: to explore the perceptions of older Irish adults aged 65 years of age or more regarding the person-centred climate of the long-term care setting in which they live. Method: a cross-sectional study design using the Person-centered Climate Questionnaire–Patient (PCQ-P) was used to survey 56 older adults in a long-term care setting. Results: overall, residents considered the setting to be hospitable, welcoming, clean and safe; the mean (SD) scale score was 5.39 (0.520). Psychosocial concerns about adapting to living in long-term care environments need to be addressed, particularly among the younger male residents when compared with older male residents (53.8% v 86.7%, P=0.018). Conclusion: older people in long-term care may prioritise different facets of person-centredness to staff. Further research of approaches used in Irish older adult long-term person-centred care delivery is warranted.


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