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End-of-Life Family Caregiving for Older Parents in China’s Rural Anhui Province*

Published online by Cambridge University Press:  21 October 2014

Dongmei Zuo Open the ORCID record for Dongmei Zuo [Opens in a new window] ,
Shuzhuo Li ,
Weiyu Mao  and
Iris Chi
Dongmei Zuo*
Affiliation:
Center for Aging and Health Research, Xi’an Jiaotong University Institute for Population and Development Studies, Xi’an Jiaotong University
Shuzhuo Li
Affiliation:
Center for Aging and Health Research, Xi’an Jiaotong University Institute for Population and Development Studies, Xi’an Jiaotong University
Weiyu Mao
Affiliation:
School of Social Work, University of Southern California
Iris Chi
Affiliation:
School of Social Work, University of Southern California
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Dongmei Zuo, Ph.D. Institute for Population and Development Studies Xi’an Jiaotong University 28 West Xianning Road Xi’an Shaanxi Province, 710049 (zuodm12@gmail.com)
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Abstract

This study examined correlates of caregiving at the end of life provided by adult children to their older parents and the role of gender of adult children in family caregiving in rural China. Data came from five waves of the Longitudinal Study of Rural Elder’s Well-Being in Anhui Province, China, over 12 years and from a post-mortality survey. Hierarchical linear modeling was used. Findings demonstrated that the birth order of adult children, prior geographic distance, and prior intergenerational support exchange were significantly associated with family caregiving at the end of life. Eldest children, compared to other siblings, provided the most end-of-life caregiving to their parents. Children cohabitating with older parents before death provided the most caregiving, compared to other siblings. Adult children who had previously exchanged instrumental support with older parents before death, especially sons, tended to provide the most caregiving, compared with that by others, at end of life.

Résumé

Cette étude a examiné les corrélats de la prestation de soins de la fin de vie fournis par les enfants adultes à leurs parents âgés et le rôle du sexe des enfants adultes en soins familiaux dans la Chine rurale. Les données proviennent de cinq vagues de l'Étude longitudinale du bien-être des personnes âgées en milieu rural dans la province de l'Anhui, en Chine, pendant 12 ans, et d'une enquête post-mortalité. On a utilisé la modélisation linéaire hiérarchique . Les résultats ont montré que l'ordre de naissance des enfants adultes, la distance géographique antérieure, et l'échange du soutien intergénérationnel antérieur étaient significativement associés à la prestation de soins de famille de la fin de vie. Les enfants les plus âgés, par rapport à d'autres frères et sœurs, fourni les plus grand soins de fin de vie pour leurs parents. Les enfants qui cohabitent avec les parents plus âgés avant leur mort, par rapport à d'autres enfants des mêmes parents, ont offert les plus grands soins. Les enfants adultes qui avaient déjà échangé le soutien instrumental avec les parents âgés avant la mort, en particulier les fils, tendaient à fournir le plus grands soins en fin de vie, par rapport à ceux d'autres.

Keywords

agingbirth orderend of lifefamily caregivingprior intergenerational support exchangerural Chinavieillissementle rang de naissancela fin de vieles soins de la familleéchange préalable de soutien intergénérationnella Chine rurale
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 33 , Issue 4: Special Issue on Aging Families , December 2014 , pp. 448 - 461
Copyright
Copyright © Canadian Association on Gerontology 2014 

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Footnotes

*

The authors acknowledge the valuable editorial assistance from Eric Lindberg. We also thank the editor for the opportunity to revise and resubmit the article. We are also very grateful to the reviewers for their thoughtful comments. This research was supported by National Natural Science Foundation of China Grant 71273205 and Humanity and the National Social Science Fund of China 14CRK003.

References

Abel, E. K. (1986). Adult daughters and care for the elderly. Feminist Studies, 12, 479–497. doi:10.2307/3177908.Google Scholar
Agree, E. M., Biddlecom, A. E., & Valente, T. W. (2005). Intergenerational transfers of resources between older persons and extended kin in Taiwan and the Philippines. Population Studies, 59, 181–195. doi:10.1080/00324720500099454.Google Scholar
Antonucci, T. C. (1990). Social supports and social relationships. In Binstock, R. H. & George, L. K. (Eds.), Handbook of aging and the social sciences (pp. 205–226). New York, NY: Academic Press.Google Scholar
Brody, E. M. (1985). Parent care as a normative family stress. Gerontologist, 25(1), 19–29. doi:10.1093/geront/25.1.19.Google Scholar
Campbell, L. D. (2010). Sons who care: Examining the experience and meaning of filial caregiving for married and never-married sons. Canadian Journal on Aging, 29(1), 73–84. doi:10.1017/S071498080999033X.Google Scholar
Caress, A.L., Chalmers, K., & Luker, K. (2009). A narrative review of interventions to support family carers who provide physical care to family members with cancer. International Journal of Nursing Studies, 46(11), 1516–1527. doi:10.1016/j.ijnurstu.2009.03.008.Google Scholar
Chan, C. L. W., & Chow, A. Y. M. (Eds.). (2006). Death, dying and bereavement: A Hong Kong Chinese experience. Hong Kong, China: Hong Kong University Press.Google Scholar
Chan, C. L. W., Ho, A. H. Y., Leung, P. P. Y., Chochinov, H. M., Neimeyer, R. A., Pang, S. M. C., & Tse, D. M. W. (2012). The blessings and the curses of filial piety on dignity at the end of life: Lived experience of Hong Kong Chinese adult children caregivers. Journal of Ethnic & Cultural Diversity in Social Work, 21(4), 277–296. doi:10.1080/15313204.2012.729177.Google Scholar
Chappell, N. L., & Kusch, K. (2007). The gendered nature of filial piety: A study among Chinese Canadians. Journal of Cross-Cultural Gerontology, 22(1), 29–45. doi:10.1007/s10823-006-9011-5.Google Scholar
Chow, N. W. S. (2001). The practice of filial piety among the Chinese in Hong Kong. In Chi, I., Chappell, N. L., & Lubben, J. (Eds.), Elderly Chinese in Pacific Rim countries: Social support and integration (pp. 125–136). Hong Kong, China: Hong Kong University Press.Google Scholar
Chudacoff, H. P., & Hareven, T. K. (1979). From the empty nest to family dissolution: Life course transitions into old age. Journal of Family History, 4(1), 69–83. doi:10.1177/036319907900400105.Google Scholar
Cong, Z., & Silverstein, M. (2010). Which sons live with their older parents in rural China?. The role of migration and intergenerational exchanges. Family Science, 1(1), 63–72. doi:10.1080/19424620903452897.Google Scholar
Cong, Z., & Silverstein, M. (2012). Caring for grandchildren and intergenerational support in rural China: A gendered extended family perspective. Ageing and Society, 32(3), 425–450. doi:10.1017/S0144686X11000420.Google Scholar
Coward, R. T., & Dwyer, J. W. (1990). The association of gender, sibling network composition, and patterns of parent care by adult children. Research on Aging, 12(2), 158–181. doi:10.1177/0164027590122002.CrossRefGoogle ScholarPubMed
Cowgill, D. O. (1974). Aging and modernization: A revision of the theory. In Gubrium, J. F. (Ed.), Latelife: Communities and environmental policies (pp.305–323). Springfield, IL: Thomas.Google Scholar
Dannefer, D., & Kelley-Moore, J. A. (2009). Theorizing the life course: New twists in the paths. In Bengtson, V., Silverstein, M., Putney, N., & Gans, D. (Eds.), Handbook of theories of aging (2nd ed.) (pp. 389–411), New York, NY: Springer.Google Scholar
Donorfio, L. M., & Sheehan, N. W. (2001). Relationship dynamics between aging mothers and caregiving daughters: Filial expectations and responsibilities. Journal of Adult Development, 8(1), 39–49. doi:10.1023/A:1026497721126.Google Scholar
Dwyer, J. W., & Coward, R. T. (1991). A multivariate comparison of the involvement of adult sons versus daughters in the care of impaired parents. Journal of Gerontology, 46(5), S259–S269. doi:10.1093/geronj/46.5.S259.Google Scholar
Elder, G. H. Jr. (1994). Time, human agency, and social change: Perspectives on the life course. Social Psychology Quarterly, 57(1), 4–15. doi:10.2307/2786971.Google Scholar
George, L. K. (2002). Research design in end-of-life research: State of science. Gerontologist, 42(Suppl. 3), 86–98. doi:10.1093/geront/42.suppl_3.86.Google Scholar
Goldstein, H. (1987). Multilevel models in educational and social research. New York, NY: Oxford University Press.Google Scholar
Gu, D. (2004). The quality of life at the end of life [In Chinese]. In Zeng, Y. & Liu, Y. (Eds.), Analysis on determinants of healthy longevity in China (pp. 347–360). Beijing, China: Peking University Press.Google Scholar
Gu, D., Gu, D., & Zhou, J. (2009). Analysis of the number of days required for full-time care before death and the cost of care in the last month of life among the Chinese elderly. In Hofmann, B. R. (Ed.), Health care costs: Causes, effects and control (pp. 51–79). New York, NY: Nova Science.Google Scholar
Gu, D., Liu, G., Vlosky, D. A., & Zeng, Y. (2007). Factors associated with place of death among the Chinese oldest old. Journal of Applied Gerontology, 26(1), 34–57. doi:10.1177/0733464806296057.Google Scholar
Gu, D., Liu, Y., Zhang, Y., Ren, H., & Zeng, Y. (2007). Analysis of number of days needing full-time care before dying among the Chinese elderly [In Chinese]. Population and Economics, 6, 51–58.Google Scholar
Gu, D., & Vlosky, D. A. (2008). Long-term care needs and related issues in China. In Garner, J. B. & Christiansen, T. C. (Eds.), Social sciences in health care and medicine (pp. 52–84). New York, NY: Nova Science.Google Scholar
Hansson, R. O., Chernovetz, M. E., Jones, W. H., & Stortz, S. (1978). Birth order and responsibility in natural settings. Journal of Social Psychology, 105(2), 307–308. doi:10.1080/00224545.1978.9924132.Google Scholar
Hermalin, A. I. (Ed.). (2002). The well-being of the elderly in Asia: A four-country comparative study. Ann Arbor, MI: University of Michigan Press.CrossRefGoogle Scholar
Horwitz, A. V., Reinhard, S. C., & Howell-White, S. (1996). Caregiving as reciprocal exchange in families with seriously mentally ill members. Journal of Health and Social Behavior, 37(2), 149–162. doi:10.2307/2137270.Google Scholar
Houser, B. B., Berkman, S. L., & Bardsley, P. (1985). Sex and birth order differences in filial behavior. Sex Roles, 13(11–12), 641–651. doi:10.1007/BF00287300.CrossRefGoogle Scholar
Hwang, K. K. (1999). Filial piety and loyalty: Two types of social identification in Confucianism. Asian Journal of Social Psychology, 2, 163–183. doi:10.1111/1467-839X.00031.Google Scholar
Izumi, S., Nagae, H., Sakurai, C., & Imamura, E. (2012). Defining end-of-life care from perspectives of nursing ethics. Nursing Ethics, 19, 608–618. doi:10.1177/0969733011436205.CrossRefGoogle ScholarPubMed
Karasik, R. J., & Conway-Turner, K. (1995). Role of siblings in adult daughters’ anticipation of caregiving. Journal of Adult Development, 2(1), 257–263. doi:10.1007/BF02251040.Google Scholar
Koh, S. K. (2002). Financial reciprocity and elder care: Understanding multiple, interdependent resource transfers [Doctoral dissertation]. Iowa State University, Ames, IA.Google Scholar
Kulik, L. (2004). The impact of birth order on intergenerational transmission of attitudes from parents to adolescent sons: The Israeli case. Journal of Youth and Adolescence, 33(2), 149–157. doi:10.1023/B: JOYO.0000013426.65751.81.Google Scholar
Lang, A. M., & Brody, E. M. (1983). Characteristics of middle-aged daughters and help to their elderly mothers. Journal of Marriage and Family, 45(1), 193–202. doi:10.2307/351308.Google Scholar
Lee, Y.-J., Parish, W. L., & Willis, R. J. (1994). Sons, daughters, and intergenerational support in Taiwan. American Journal of Sociology, 99(4), 1010–1041. doi:10.1086/230370.Google Scholar
Li, Q. (2001). Rural-urban migrants and their remittance in China [In Chinese]. Sociology Studies, 4, 64–76.Google Scholar
Li, Y., Doring, O., Fang, L., Li, F., & Baoqi, S. (2005). End-of-life care in China: A view from Beijing. In Black, R. H. & Merrick, J. C. (Eds.), End-of-life decision making: A cross-national study (pp. 33–59). Cambridge, MA: MIT Press.Google Scholar
Lin, I. F., Goldman, N., Weinstein, M., Lin, Y. H., Gorrindo, T., & Seeman, T. (2003). Gender differences in adult children’s support of their parents in Taiwan. Journal of Marriage and Family, 65(1), 184–200. doi:10.1111/j.1741-3737.2003.00184.x.CrossRefGoogle Scholar
Logan, J. R., Bian, F., & Bian, Y. (1998). Tradition and change in the urban Chinese family: The case of living arrangements. Social Forces, 76(3), 851–882. doi:10.1093/sf/76.3.851.Google Scholar
Lopata, H. Z. (1973). Widowhood in an American city. Cambridge, MA: Schenkman.Google Scholar
Mao, W., & Chi, I. (2011). Filial piety of children as perceived by aging parents in China. International Journal of Social Welfare, 20(Suppl. s1), S99–S108. doi:10.1111/j.1468-2397.2011.00826.x.Google Scholar
McNamara, B., & Rosenwax, L. (2010). Which carers of family members at the end of life need more support from health services and why? Social Science & Medicine, 70(7), 1035–1041. doi:10.1016/j.socscimed.2009.11.029.Google Scholar
Rawlins, J. M., & Spencer, M. (2002). Daughters and wives as informal care givers of the chronically ill elderly in Trinidad. Journal of Comparative Family Studies, 33, 125–137.Google Scholar
Read, T., & Wuest, J. (2007). Daughters caring for dying parents: A process of relinquishing. Qualitative Health Research, 17(7), 932–944. doi:10.1177/1049732307306123.Google Scholar
Ross, C. E. (1987). The division of labor at home. Social Forces, 65(3), 816–833. doi:10.1093/sf/65.3.816.Google Scholar
Salmon, C. (2003). Birth order and relationships: Family, friends, and sexual partners. Human Nature, 14(1), 73–88. doi:10.1007/s12110-003-1017-x.Google Scholar
Shi, Y., & Wang, G. (Eds.). (2010). Status of family caregiving at the end of life in Chinese cities and implications on policies [In Chinese]. Shanghai, China: Shanghai Technology and Education Press.Google Scholar
Silverstein, M., Cong, Z., & Li, S. (2007). Grandparents who care for their grandchildren in rural China: Benefactors and beneficiaries. In Cook, I. G. & Powell, J. L. (Eds.), New perspectives on China and aging (pp. 49–71). New York, NY: Nova Science.Google Scholar
Silverstein, M., Conroy, S. J., Wang, H., Giarrusso, R., & Bengtson, V. L. (2002). Reciprocity in parent–child relations over the adult life course. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(1), S3–S13. doi:10.1093/geronb/57.1.S3.Google Scholar
Smith, D. S. (1979). Life course, norms, and the family system of older Americans in 1900. Journal of Family History, 4(3), 285–298. doi:10.1177/036319907900400303.Google Scholar
Smith, T. E. (1984). Sex and sibling structure: Interaction effects upon the accuracy of adolescent perceptions of parental orientations. Journal of Marriage and Family, 46(4), 901–907. doi:10.2307/352538.Google Scholar
Song, L., & Li, S. (2008). Sons and daughters: Effects of out-migration on division of intergenerational support in rural China [In Chinese]. Journal of Xi’an Jiaotong University, 28(3), 10–21.Google Scholar
Spitze, G., & Logan, J. (1990). Sons, daughters and intergenerational social support. Journal of Marriage and the Family, 52(2), 420–430. doi:10.2307/353036.Google Scholar
Spitze, G., & Logan, J. R. (1991). Sibling structure and intergenerational relations. Journal of Marriage and Family, 53(4), 871–884. doi:10.2307/352994.Google Scholar
Stoller, E. P., & Earl, L. L. (1983). Help with activities of everyday life: Sources of support for the noninstitutionalized elderly. Gerontologist, 23(1), 64–70. doi:10.1093/geront/23.1.64.Google Scholar
Stajduhar, K., Funk, L., Toye, C., Grande, G. E., Aoun, S., & Todd, C. J. (2010). Home-based family caregiving at the end of life: A comprehensive review of published quantitative research (1998–2008). Palliative Medicine, 24(6), 573–593. doi:10.1177/0269216310371412.Google Scholar
Wachwithan, P. (2000). Examining intergenerational resource transfers: The relevance of individual and family characteristics and reciprocity concepts [Doctoral dissertation]. University of Minnesota, Minneapolis, MN.Google Scholar
Wang, D. (2004). Ritualistic coresidence and the weakening of filial practice in rural China. In Ikels, C. (Ed.), Filial piety: Practice and discourse in contemporary East Asia (pp. 16–33). Stanford, CA: Stanford University Press.Google Scholar
Wang, X. S., Di, L. J., Reyes-Gibby, C. C., Guo, H., Liu, S. J., & Cleeland, C. S. (2004). End-of–life care in urban areas of China: A survey of 60 oncology clinicians. Journal of Pain and Symptom Management, 27(2), 125–132. doi:10.1016/j.jpainsymman.2003.06.002.Google Scholar
Yang, B. (2008). Mencius translation and annotation [In Chinese]. Beijing, China: Zhonghua Book Company.Google Scholar
Zhan, H. J. (2004a). A study on the nursing of Chinese eldest-old before their death [In Chinese]. Chinese Journal of Population Science, (Suppl.), 121–123.Google Scholar
Zhan, H. J. (2004b). Through gendered lens: Explaining Chinese caregivers’ task performance and care reward. Journal of Women & Aging, 16(1–2), 123–142. doi:10.1300/J074v16n01_09.Google Scholar
Zhan, H. J., & Montgomery, R. J. V. (2003). Gender and elder care in China: The influence of filial piety and structural constraints. Gender & Society, 17(2), 209–229. doi:10.1177/0891243202250734.Google Scholar
Zhang, H. (2007). China’s new rural daughters coming of age: Downsizing the family and firing up cash-earning power in the new economy. Signs, 32(3), 671–698. doi:10.1086/510923.Google Scholar
Zhang, W., & Li, S. (2005). Gender differences in activity of daily living of the elderly in rural china: Evidence from Chaohu. Journal of Women & Aging, 17(3), 73–89. doi:10.1300/J074v17n03_06.Google Scholar
Zhou, L. (2010). Intergenerational transfers in rural China: Do children’s gender and birth order matter? [Doctoral dissertation]. University of Southern California, Los Angeles, CA.Google Scholar
Zimmer, Z., & Korinek, K. (2010). Shifting coresidence near the end of life: Comparing decedents and survivors of a follow-up study in China. Demography, 47(3), 537–554. doi:10.1353/dem.0.0116.Google Scholar
Zuo, D., Wu, Z., & Li, S. (2011). Age and intergenerational exchange among older parents in rural China. International Journal of Social Welfare, 20(Suppl. S1), S30–S46. doi:10.1111/j.1468-2397.2011.00817.x.Google Scholar