Older People’s Long-Term Care Preferences in China: The Impact of Living with Grandchildren on Older People’s Willingness and Family Decisions
Abstract
:1. Introduction
2. Model and Hypothesis Development
2.1. Social Exchange Theory and Demonstration Effect
2.2. The Main Effect of Living with Grandchildren on Institutional Care Preferences
2.3. The Mediating Effect of Family Members’ Attitudes
2.4. The Mediating Effect of Life Satisfaction
2.5. The Heterogeneous Effect of Older People’s Marital Status
2.6. The Heterogeneous Effects of Gender
3. Materials and Methods
3.1. Sample and Data Collection
3.2. Measures
3.2.1. Institutional Care Preferences
3.2.2. Living with Grandchildren
3.2.3. Family Members’ Attitudes
3.2.4. Life Satisfaction
3.2.5. Single Older People
3.2.6. Gender
3.2.7. Control Variables
3.3. Analytical Strategy
4. Results
4.1. Baseline Effects
4.2. Heterogeneous Effects
5. Theoretical Implications
6. Practical Implications
7. Limitations and Future Research
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Operationalization | Mean | SD |
---|---|---|---|
Institutional care preference | 1 = there are some conditions under which I would like to live in a nursing home, 0 = I do not want to live in a nursing home under any conditions | 0.28 | 0.45 |
Living with grandchildren | Number of grandchildren under the age of 18 years old you live with | 0.30 | 0.67 |
Family members’ attitudes | 1 = agree to send you to a nursing home/old age home, 0 = disagree | 0.29 | 0.45 |
Life satisfaction | 1 = satisfied with life, 0 = unsatisfied with life | 0.75 | 0.43 |
The single older | 1 = single or separated/divorced and 0 = married or partnered | 0.33 | 0.47 |
Gender | 1 = female, 0 = male | 0.52 | 0.50 |
Age | Measured in years | 70.7 | 8.14 |
Education | 1 = less than a high school level, 2 = high school, and 3 = college and above | 1.22 | 0.54 |
ADL | Degree of activity of daily living | 1.07 | 0.24 |
IADL | Degree of instrumental activity of daily living | 1.20 | 0.37 |
Homeownership | 1 = owned commodity housing in destination counties, 0 = others | 0.84 | 0.37 |
Social security benefits | older people’s primary income, including Enterprise Employee Basic Pensions (EEBP), Urban-Rural Resident Social Pensions (URRSP), poverty funds, and advanced-age allowances | 5.99 | 1.72 |
Family economic status | Household income over the last year | 9.10 | 1.41 |
Variables | Institutional Care Preference | Family Members’ Attitude | Institutional Care Preference | Life Satisfaction | Institutional Care Preference | Institutional Care Preference |
---|---|---|---|---|---|---|
(1) | (2) | (3) | (4) | (5) | (6) | |
Living with grandchildren | −0.0278 *** | −0.0358 * | 0.0112 * | 0.0171 | ||
(0.0079) | (0.0189) | (0.0067) | (0.0218) | |||
Family members’ attitude | 0.1838 *** | 0.1685 *** | ||||
(0.0378) | (0.0369) | |||||
Life satisfaction | −0.0640 *** | −0.0622 * | ||||
(0.0117) | (0.0307) | |||||
Age | −0.0074 *** | −0.0039 * | −0.0053 *** | 0.0068 *** | −0.0068 *** | −0.0048 *** |
(0.0007) | (0.0015) | (0.0014) | (0.0006) | (0.0007) | (0.0014) | |
Education | 0.0211* | 0.0142 | 0.0109 | 0.0089 | 0.0237 ** | 0.0153 |
(0.0088) | (0.0176) | (0.0178) | (0.0091) | (0.0088) | (0.0179) | |
ADL | 0.0420 | 0.0291 | −0.0891 | −0.0648 * | 0.0470 | −0.0912 |
(0.0377) | (0.0657) | (0.0638) | (0.0296) | (0.0387) | (0.0628) | |
IADL | −0.0346 | −0.0098 | 0.0109 | −0.1479 *** | −0.0474 + | −0.0030 |
(0.0252) | (0.0543) | (0.0522) | (0.0198) | (0.0256) | (0.0512) | |
Homeownership | 0.0238 | 0.0194 | −0.0313 | −0.0027 | 0.0254 + | −0.0439 |
(0.0150) | (0.0362) | (0.0344) | (0.0127) | (0.0150) | (0.0353) | |
Social security benefits | 0.0495 *** | 0.0478 ** | −0.0031 | 0.0145 ** | 0.0519 *** | 0.0038 |
(0.0056) | (0.0154) | (0.0135) | (0.0049) | (0.0056) | (0.0133) | |
Family economic status | −0.0123 + | 0.0040 | −0.0216 | 0.0240 *** | −0.0112 + | −0.0261 + |
(0.0065) | (0.0176) | (0.0159) | (0.0054) | (0.0065) | (0.0158) | |
Provincial FE | Yes | Yes | Yes | Yes | Yes | Yes |
N | 8232 | 1752 | 950 | 8876 | 8177 | 940 |
Pseudo R2 | 0.1230 | 0.1036 | 0.2275 | 0.0916 | 0.1245 | 0.2443 |
Variables | Institutional Care Preference | Family Members’ Attitude | Institutional Care Preference | Life Satisfaction | Institutional Care Preference | Institutional Care Preference | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Single | With Spouse | Single | With Spouse | Single | With Spouse | Single | With Spouse | Single | With Spouse | Single | With Spouse | |
(1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | (10) | (11) | (12) | |
Living with grandchildren | −0.0317 * | −0.0270 ** | −0.1337 ** | −0.0156 | 0.0075 | 0.0114 * | −0.0693 | 0.0538 | ||||
(0.0137) | (0.0097) | (0.0467) | (0.0230) | (0.0129) | (0.0800) | (0.0600) | (0.0436) | |||||
Family members’ attitude | 0.4384 *** | 0.157 0 *** | 0.4517 *** | 0.1424 *** | ||||||||
(0.1274) | (0.0445) | (0.1240) | (0.0424) | |||||||||
Life satisfaction | −0.0750 *** | −0.0549 *** | −0.1313 | −0.0784 | ||||||||
(0.0188) | (0.0149) | (0.0800) | (0.0488) | |||||||||
Age | −0.0066 *** | −0.0074 *** | −0.0064 * | −0.0028 | −0.0060 | −0.0050 ** | 0.0063 *** | 0.0078 *** | −0.0057 *** | −0.0068 *** | −0.0063 | −0.0042 * |
(0.0011) | (0.0009) | (0.0031) | (0.0021) | (0.0049) | (0.0019) | (0.0011) | (0.0009) | (0.0011) | (0.0009) | (0.0052) | (0.0019) | |
Education | 0.0363 * | 0.0156 | 0.0820 + | 0.0135 | 0.1413 | −0.0011 | 0.0023 | 0.0042 | 0.0366* | 0.0180 + | 0.1547 | 0.0016 |
(0.0180) | (0.0104) | (0.0466) | (0.0211) | (0.1065) | (0.0210) | (0.0212) | (0.0102) | (0.0180) | (0.0104) | (0.0947) | (0.0211) | |
ADL | 0.0415 | 0.0300 | 0.0097 | −0.0143 | −0.3033 + | 0.0201 | −0.0652 | −0.0530 | 0.0464 | 0.0343 | −0.2201 | 0.0095 |
(0.0515) | (0.0532) | (0.1067) | (0.1008) | (0.1738) | (0.0891) | (0.0443) | (0.0414) | (0.0528) | (0.0546) | (0.1756) | (0.0909) | |
IADL | −0.0542 | −0.0055 | 0.0436 | 0.0136 | 0.1558 | −0.0809 | −0.1264 *** | −0.1801 *** | −0.0694 * | −0.0169 | 0.0185 | −0.0912 |
(0.0347) | (0.0358) | (0.0934) | (0.0779) | (0.1524) | (0.0729) | (0.0300) | (0.0277) | (0.0353) | (0.0363) | (0.1582) | (0.0733) | |
Homeownership | 0.0241 | 0.0123 | −0.0252 | 0.0381 | −0.0622 | −0.0677 | −0.0279 | 0.0236 | 0.0249 | 0.0146 | −0.0987 | −0.0864 |
(0.0204) | (0.0214) | (0.0638) | (0.0523) | (0.0861) | (0.0536) | (0.0199) | (0.0171) | (0.0203) | (0.0215) | (0.0863) | (0.0545) | |
Social security benefits | 0.0355 *** | 0.0566 *** | 0.0480 | 0.0567 ** | −0.0096 | −0.0127 | 0.0063 | 0.0161 ** | 0.0389 *** | 0.0588 *** | 0.0241 | −0.0040 |
(0.0101) | (0.0068) | (0.0359) | (0.0191) | (0.0420) | (0.0188) | (0.0098) | (0.0056) | (0.0101) | (0.0069) | (0.0403) | (0.0194) | |
Family economic status | −0.0023 | −0.0144 + | 0.0412 | −0.0144 | −0.0294 | −0.0174 | 0.0274 ** | 0.0239 *** | −0.0026 | −0.0134 | −0.1053 + | −0.0194 |
(0.0108) | (0.0082) | (0.0389) | (0.0228) | (0.0525) | (0.0214) | (0.0102) | (0.0064) | (0.0109) | (0.0082) | (0.0626) | (0.0221) | |
Provincial FE | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
N | 2694 | 5505 | 409 | 1197 | 409 | 1197 | 2822 | 5992 | 2672 | 5472 | 409 | 1197 |
Pseudo R2 | 0.1235 | 0.1254 | 0.1549 | 0.0883 | 0.3512 | 0.2160 | 0.1181 | 0.0931 | 0.1261 | 0.1263 | 0.4036 | 0.2384 |
Variables | Institutional Care Preference | Family Members’ Attitude | Institutional Care Preference | Life Satisfaction | Institutional Care Preference | Institutional Care Preference | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | |
(1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | (10) | (11) | (12) | |
Living with grandchildren | −0.0298 ** | −0.0304 ** | −0.1055 *** | 0.0379 | 0.0072 * | 0.0113 | 0.0140 | 0.0215 | ||||
(0.0110) | (0.0114) | (0.0299) | (0.0290) | (0.0095) | (0.0096) | (0.0362) | (0.0424) | |||||
Family members’ attitude | 0.3467 *** | 0.1740 ** | 0.3088 ** | 0.1610 ** | ||||||||
(0.1052) | (0.0548) | (0.0955) | (0.0542) | |||||||||
Life satisfaction | −0.0634 *** | −0.0755 *** | −0.1078 + | −0.0737 | ||||||||
(0.0164) | (0.0169) | (0.0569) | (0.0591) | |||||||||
Age | −0.0082 *** | −0.0072 *** | −0.0053 * | −0.0028 | −0.0102 *** | −0.0067 ** | 0.0061 *** | 0.0075 *** | −0.0075 *** | −0.0066 *** | −0.0089 ** | −0.0059 * |
(0.0010) | (0.0010) | (0.0023) | (0.0024) | (0.0029) | (0.0025) | (0.0009) | (0.0009) | (0.0010) | (0.0010) | (0.0029) | (0.0026) | |
Education | 0.0345 * | 0.0189 | 0.0662 * | −0.0160 | 0.0401 | −0.0165 | 0.0327 * | −0.0003 | 0.0379 ** | 0.0221 + | 0.0666 | −0.0151 |
(0.0137) | (0.0119) | (0.0279) | (0.0256) | (0.0380) | (0.0314) | (0.0156) | (0.0113) | (0.0137) | (0.0118) | (0.0421) | (0.0310) | |
ADL | 0.0052 | 0.0718 | 0.0044 | 0.0283 | −0.2627 + | −0.4906 + | −0.0564 | −0.0834 + | 0.0071 | 0.0765 | −0.2302 | −0.4516 + |
(0.0498) | (0.0593) | (0.0899) | (0.1239) | (0.1436) | (0.2507) | (0.0372) | (0.0493) | (0.0512) | (0.0606) | (0.1469) | (0.2486) | |
IADL | −0.0118 | −0.0336 | 0.0701 | −0.0773 | 0.0820 | 0.2142 | −0.1418 *** | −0.1593 *** | −0.0227 | −0.0514 | 0.0331 | 0.1593 |
(0.0337) | (0.0388) | (0.0793) | (0.0926) | (0.1124) | (0.1534) | (0.0265) | (0.0309) | (0.0344) | (0.0392) | (0.1151) | (0.1498) | |
Homeownership | 0.0508 * | −0.0151 | 0.0260 | 0.0172 | −0.0118 | 0.0021 | −0.0010 | 0.0002 | 0.0569 ** | −0.0177 | −0.0071 | −0.0381 |
(0.0200) | (0.0229) | (0.0532) | (0.0566) | (0.0717) | (0.0631) | (0.0167) | (0.0198) | (0.0201) | (0.0230) | (0.0670) | (0.0699) | |
Social security benefits | 0.0475 *** | 0.0504 *** | 0.0287 | 0.0613 ** | −0.0117 | 0.0218 | 0.0157 * | 0.0119 + | 0.0503 *** | 0.0525 *** | 0.0002 | 0.0263 |
(0.0084) | (0.0077) | (0.0268) | (0.0214) | (0.0261) | (0.0246) | (0.0074) | (0.0065) | (0.0084) | (0.0077) | (0.0266) | (0.0238) | |
Family economic status | −0.0074 | −0.0140 | 0.0391 | −0.0136 | −0.0402 | −0.0307 | 0.0203 ** | 0.0342 *** | −0.0060 | −0.0126 | −0.0438 | −0.0414 |
(0.0093) | (0.0094) | (0.0288) | (0.0264) | (0.0316) | (0.0265) | (0.0077) | (0.0077) | (0.0093) | (0.0095) | (0.0320) | (0.0270) | |
Provincial FE | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
N | 4122 | 4053 | 807 | 806 | 807 | 806 | 4500 | 4373 | 4094 | 4026 | 807 | 806 |
Pseudo R2 | 0.1532 | 0.1099 | 0.1400 | 0.1042 | 0.3239 | 0.2475 | 0.1027 | 0.1084 | 0.1544 | 0.1126 | 0.3462 | 0.2743 |
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Deng, T.; Fan, Y.; Wu, M.; Li, M. Older People’s Long-Term Care Preferences in China: The Impact of Living with Grandchildren on Older People’s Willingness and Family Decisions. Int. J. Environ. Res. Public Health 2022, 19, 12455. https://doi.org/10.3390/ijerph191912455
Deng T, Fan Y, Wu M, Li M. Older People’s Long-Term Care Preferences in China: The Impact of Living with Grandchildren on Older People’s Willingness and Family Decisions. International Journal of Environmental Research and Public Health. 2022; 19(19):12455. https://doi.org/10.3390/ijerph191912455
Chicago/Turabian StyleDeng, Tongbo, Yafan Fan, Mengdi Wu, and Min Li. 2022. "Older People’s Long-Term Care Preferences in China: The Impact of Living with Grandchildren on Older People’s Willingness and Family Decisions" International Journal of Environmental Research and Public Health 19, no. 19: 12455. https://doi.org/10.3390/ijerph191912455