In the absence of broad-based formal health insurance and social protection systems in much of sub-Saharan Africa, the family acts as the key provider of support to older people. This paper furthers our understanding of family support mechanisms in the context of low-income countries by focusing on support from outside the household, which has been less studied so far. By using the data of 3,114 people aged ≥50 from the second round of the Senegalese Poverty and Family Structure Survey, the paper examines how the living arrangements of older people are associated with receiving transfers from non-coresident kin. Our findings highlight a net advantage of women receiving net positive family transfers compared to men for some living arrangements. Results also indicate that living without a husband or an adult significantly increases the likelihood of older women receiving support from non-resident family members compared to those who live with both spouse and a younger adult child. However, these differences are not significant among older men. These results suggest that in constrained settings, decision-makers should consider older people's living arrangements and potential external family support when designing public policies towards them, so as to optimise the impact of policy and interventions on their welfare.

Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

Labor market conditions in Greece have severely deteriorated during the crisis, affecting youths the most. Using the Greek crisis as a case-study, this paper examines the role of the family as a social safety net for its young members. Specifically, we test the relationship between youth labor outcomes and parental co-residence, whether this relationship has become stronger during the crisis, and the degree to which the relationship is causal. Our results confirm that the parental home is a refuge both for jobless youth and for those in poorly paid, insecure jobs, and this role has intensified during the crisis. We find no reverse causality between co-residence and employment status for young men, and significant reverse causality for women. This finding implies that all youths live in the parental home when they are in need themselves, but it is young women not men who live with parents when parents are in need or for cultural reasons.

Most of the extant literature on the fertility history and social networks of older adults has focused on advanced societies. Nevertheless, a limited number of studies have explored how culturally preferred family structures or living arrangements are related to older adults’ social networks in developing societies. This study examined these issues in the Chinese context and paid particular attention to the filial piety and preference for sons dominating Chinese society. Using nationally representative data of adults aged 60 and over from China Longitudinal Aging Social Survey in 2016, we constructed family and friend network scores following previous studies and developed linear models using multiple imputation for the missing data. The results suggested that childless older adults were the most disadvantaged in receiving support from family networks. Despite China's patrilineal culture, daughters were important sources of support. In terms of friend networks, older men who had no sons were least likely to receive support while co-residing with a partner and a son(s) might benefit them. Further analysis revealed that older rural women, but not older urban women, also had more support from friend networks if living with sons, implying urban–rural differences. Given the impact of social networks on older adults’ health and wellbeing, older Chinese people with no sons might need more support from other sources, such as aged-care programmes from public institutions, to achieve healthy ageing.

Older individuals who are in poor health or who lack spousal support are in many ways vulnerable in contemporary China. Declines in family size, combined with improvements in life expectancy and the out-migration of young adults from rural areas, have reduced the pool of potential care-givers for a growing number of older individuals. At the same time, state support for elderly people remains inadequate, further emphasising families’ role in care provision. This paper uses couple-level panel data from the 2012, 2014 and 2016 China Family Panel Studies to examine whether older couples with health-care or other needs receive help in the form of intergenerational co-residence. Multinomial logistic regressions are used to examine factors associated with the intergenerational solidarity framework from the older parents’ perspective that could motivate co-residence. Results show that when mothers report activity limitations or poor word recall at baseline, or when at least one parent has activity limitations in both waves, the probability of co-residence in both waves increases. Further, when both parents have depression at baseline, or when a parent loses a spouse, the probability of transitioning to co-residence increases. Findings suggest that adult children in present-day China do respond to parental needs by living together. Nevertheless, going forward, the state will likely have to play a greater role in old-age care provision.

The aim of this paper is to investigate the role that the marital status of children has in shaping the living arrangements of their widowed mothers and themselves and to explain the increase in the proportion of elderly widows living alone, which grew by 23.2% in the USA between 1970 and 1990. We propose a model where living arrangements are determined as the outcome of a game between the mother and her child, and where the fundamentals of the model depend on children's marital status. We estimate the model using 1970 data. We calculate the accuracy of the estimation and we obtain an excellent fit. Using the same measure of accuracy, the estimated model predicts that changes in the incomes of both the widow and her offspring and changes in the children's marital status generate more than the 83% of the increase in the number of widows living alone.

Increased mortality after spousal bereavement has been observed in many populations. Few studies have investigated the widowhood effect in a traditional culture where the economy is underdeveloped. The reasons for the widowhood effect and its gender dynamic are not well understood. In this study, we assessed whether the widowhood-associated excess mortality exists and differs by gender and living arrangement in rural China. We used a six-wave panel of data derived from rural people over 60 years old in the Chaohu region of China. Cox regression analyses suggest that there was a positive effect of spousal loss on mortality for older rural Chinese and this effect was gender different. Our findings also suggest that living with adult children after spousal loss played a protective role in reducing the risk of older men's death, though it tended to increase older men's mortality risk in general.

This article investigates the determinants of preference for intergenerational co-residence and examines the effects of living arrangement concordance (i.e. having a match between preference and reality) on the subjective wellbeing (SWB) of older Chinese. Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) national baseline conducted in 2011. This allows for two different measures of the affective approach to SWB: depression and happiness. This article found living arrangement preference is indicative of need, cultural norms and current living arrangement experiences. The results support the hypothesis of discrepancy theories that having living arrangement concordance improves older parents’ SWB (i.e. depressive symptoms and happiness). In addition, the previously predictive effects of the actual living arrangement on SWB lost significance when actual living arrangement and concordance were added simultaneously. Living in a preferred arrangement appears to be more important than living in a traditional arrangement from the point of view of older adults’ SWB. Programmes designed to improve wellbeing in later life should not assume that there is a one-size-fits-all model for all; instead, older people should be given more choices of living arrangements.

In many parts of the world, grandparents live with their grandchildren in ‘skipped-generation households’ in which no parent resides. In Thailand, this living arrangement is more common in rural areas where parents often migrate to find employment. The focus of this article is on how grandparents make the decision to live in skipped-generation households. Our study is based upon open-ended interviews with 48 grandparents who lived in three rural areas of Thailand. Using an interpretative phenomenological approach, the analysis uncovers several factors that contribute to grandparents’ decisions about their living arrangements. These factors include: norms about care-giving and family obligation, inadequate child-care options, the need for financial support, problematic relationships within the family and a desire for companionship. We also identify three different decision-making patterns: grandparents initiating the decision to provide grandchild care, adult children asking grandparents to assume this role and adult children abandoning grandchildren to the grandparents. Based upon these findings, we provide implications for practice that address the conditions of grandparents and their family members.

In this paper, we examine predictors and consequences of living arrangements among community-dwelling older Singaporeans. We take a holistic approach and consider a range of social and economic as well as emotional and physical wellbeing indicators. Two waves (2009, 2011) of the Panel on Health and Ageing of Singaporean Elderly (PHASE) are analysed to (a) provide an overview of living arrangements in 2009 and assess the extent to which living arrangements change by 2011; (b) examine the predictors of living arrangements in 2009; and (c) examine the consequences of living arrangements over a two-year period. The majority (88%) of older Singaporeans co-reside with either their spouse and/or children. A small yet growing proportion live with others (5%) or live alone (6%). Very little change in living arrangements is observed over the two years. Our results show that women, the oldest-old and older adults with fewer children are more likely to live alone. Older adults who live alone are not particularly disadvantaged compared to those who live with their spouse and children or spouse only in their social and economic wellbeing. It is, in fact, older adults who live with their children that are disadvantaged in many aspects of social, economic and mental wellbeing. Measures to engage older adults living with their families (along with those living alone and with others) in broader social activities are imperative.

Sub-Saharan Africa's older population is projected to nearly double in size by 2030. At the same time, demographic changes have caused major shifts in the units primarily responsible for the care of older adults: the family and household. The purpose of this paper is to examine the relationship between household composition and health at older ages in rural Malawi. We use data from the Malawi Longitudinal Study of Families and Health, which contains detailed information on household and family structure, along with measures of mental and physical health (from the Short Form-12). We focus on several measures of living arrangements that are expected to be associated with health: overall household size, sex composition and kin structure (based on co-residence with offspring and grandchildren). Results show that: (a) older women who co-reside with offspring have better mental and physical health compared to those living only with grandchildren; (b) older men who live in larger households or in households with a higher proportion of females have better physical health.

China is experiencing rapid urbanisation and population ageing, alongside sometimes contentious rural land consolidation. These on-going social, economic, political and demographic changes are especially problematic for older people in rural areas. In these regions, social and institutional support arrangements are less developed than in urban areas; older people have few options for re-settlement but are resistant to or incapable of adjusting to high-rise apartment living. In 2012–13, we gathered rich qualitative and quantitative data on over 600 older residents in 12 villages under the jurisdiction of City L in north-east coastal China to analyse residents’ living arrangement choices during the village renovation process. We compared villages with and without senior centres to shed light on the correlates of co-residence and independent living. Senior centres play a role in balancing the burden on rural Chinese families resulting from population ageing, smaller families, widespread migration for work, and the rapid urbanisation that is restructuring land rights and social support arrangements.

Previous studies show a decline in parent–child co-residence among the elderly. This study examined the effect of living away from adult children on upward intergenerational monetary transfers by analysing a 2006 survey of 19,947 persons aged 60 and above and selected from 20 provinces in China. Results indicate that elderly who were not co-residing but had at least one adult child living in another community/village within the city/county were likely to receive more intergenerational monetary transfers than those who were living with children. Living close to children, rather than co-residing with them, might be the primary living arrangement for older Chinese people in the foreseeable future. The findings have important programme and policy implications for countries such as China, which has the largest elderly population in the world. There is a strong need for the development of specific public care support systems focused on the elderly population, in general, and elderly in rural areas, in particular.

There is limited research on the living arrangements of older adults with disabilities, especially research that combines household composition and housing characteristics. This paper addresses that gap with two complementary sets of logistic regression models: first, estimating the odds of disability by household composition and housing type and, second, estimating the odds of disability by living arrangement within gender and age sub-groups. Data come from the 2012 American Community Survey (N = 504,371 respondents aged 65 and older), which includes six measures of disability: cognitive, ambulatory, independent living, self-care, vision and hearing. Living alone, with children or with others was associated with higher odds of any disability, compared with living with a spouse only. Compared to those living in a single-family home, living in a mobile home or other temporary structure, or large apartment building was associated with higher odds of disability. Having a disability was associated with lower rates of living with a spouse only, alone, in a single-family home or in a small or mid-sized apartment building and higher rates of all other living arrangements. Sub-group analyses revealed differences in the relationship between living arrangements and disability by gender and age group. This information provides a baseline from which to observe trends in living arrangements and disability for older adults in the United States of America.

China has seen a rapid decline of the traditional multi-generational household and an increase in rural-to-urban migration, raising concerns about a possible breakdown of the informal support system. Against this background, the paper looks at family care-giving (or the absence thereof) to parents in three different living arrangements: with any child or child-in-law (co-resident); independent with at least one child living in the same community (networked); and without any children in either the household or the community (isolated). It also compares the care-giving arrangements of single elders to those living with a spouse. The sample, which is derived from the comprehensive China Health and Retirement Longitudinal Study (CHARLS), contains data on 887 functionally impaired individuals aged 60 and above. The findings suggest that married parents are mostly cared for by their spouse, even if they co-reside with adult children. Proximity to children is particularly important for single elders, who are more likely to lack a care-giver when living independently. There appears to be a hierarchy in family care responsibilities, where children step in as care-givers only when the spouse is no longer able to fulfil this role. While these findings imply a significant deviation from traditional practices and norms of ‘filial piety’, they can be interpreted as a rational adaptation to the changed economic circumstances in rural China.

Being married reduces the mortality risk of older persons. More generally, living arrangements that include co-residence with a source of support and a close care-giver are associated with a lower mortality risk. We build a detailed typology of private and collective living arrangements, including marital status, and check its association with mortality risks, controlling for health status. Using administrative data from the population register, we identify the living arrangement of all individuals aged 65 years and over living in Belgium as at 1 January 2002, and their survival during the year 2002. Data on health status are extracted from the 2001 census. We use binary logistic regression with the probability to die as outcome and living arrangement, health, age and gender as covariates. Our results show that mortality is more closely associated with actual living arrangements than with marital status. This association is age and gender-specific and remains even at very old ages. Living with a spouse is confirmed to be beneficial for survival but in older age living alone becomes more favourable. Of all living arrangements, older persons living in religious communities experience the lowest mortality risk whereas those living in nursing homes experience the highest risk.

This study examined how intergenerational exchanges with sons and daughters predicted older parents’ likelihood of co-residing with a son prior to death in a rural area of China’s Anhui Province. Our investigation drew on theories of contingent co-residence, modernization, and social exchange, conceptualizing co-residence as having practical and symbolic importance in rural Chinese culture. The sample included 470 older parents, reported as deceased during 2001–2009, and their posthumous informants. We used logistic regression to assess intergenerational support and cohesion as predictors of co-residence with a son just prior to death. Older parents who provided instrumental support to, and received instrumental support from, sons and had better emotional relationships with sons were more likely than their counterparts to co-reside with a son at the end of life. Living with sons demonstrates filial piety for older parents at the end of life, but its realization is sensitive to intergenerational transactions.

The objective of this study was to examine brain injury professionals’ perspectives on the future concerns of families of persons with brain injuries in the United States of America. A total of 28 persons in leadership positions with the Brain Injury Association of America (BIAA) participated. Through qualitative data analysis of an open-ended question in an electronic survey containing both qualitative and quantitative questions, participants identified future concerns related to future caregiving responsibilities, financial concerns, living arrangements, recovery, access to professional care, relationships and employment. The findings indicate that many families are unprepared to meet the future care and support needs of their injured family members.

This paper examines how the relationships between the factors (predisposing, enabling and illness) of the 1973 Andersen framework and service use are influenced by changes in the caring role in older women of the 1921–26 cohort of the Australian Longitudinal Study on Women's Health. Outcome variables were the use of three formal community support services: (a) nursing or community health services, (b) home-making services and (c) home maintenance services. Predictor variables were survey wave and the following carer characteristics: level of education, country of birth, age, area of residence, ability to manage on income, need for care, sleep difficulty and changes in caring role. Carer changes were a significant predictor of formal service use. Their inclusion did not attenuate the relationship between the Andersen framework factors and service use, but instead provided a more complete representation of carers' situations. Women were more likely to have used support services if they had changed into or out of co-resident caring or continued to provide co-resident care for a frail, ill or disabled person, needed care themselves, and reported sleep difficulties compared with women who did not provide care. These findings are important because they indicate that support services are particularly relevant to women who are changing their caring role and who are themselves in need of care.