Hong Kong Chinese aging adults voice financial care expectations in changing family and sociocultural contexts: implications for policy and services

Experience of Chinese Recent Retirees on the Effects of Retirement on Healthy Ageing in Shenzhen and Hong Kong

This study examined perspectives of recent retirees in Shenzhen and Hong Kong on how retirement influenced their healthy ageing. It investigated retirees' perceptions of healthy ageing and the ways in which healthy ageing connected with retirees' transition into retirement. A qualitative design with narrative interviews was used to interview twelve recent retirees in Shenzhen and thirteen in Hong Kong. The participants elaborated their perspectives on healthy ageing, which covered physical, mental, social, and financial domains. Retirees in both cities identified healthy ageing as maintaining an independent life and avoiding becoming a burden on family members. This study found that retirement declined physical health (in parallel with raised awareness of health promotion), posed both negative and positive influences on mental health, and shrank peripheral social networks of retirees. In addition, regional social welfare systems have different impacts on retirees' financial security and social participation. Retirees in Hong Kong reported higher stress of financial security and a strong desire for labor participation. Migrant-local welfare gaps were documented by retirees in Shenzhen. This study suggested that retirement planning, establishing a multi-pillar retirement-protection system, and narrowing the welfare gap between migrants and local residents should be implemented to reinforce healthy ageing.

The Influence of Parent- and Adult Child-level Factors on Intergenerational Relationship Quality: A Study of Chinese Families with Multiple Children in Hong Kong

Intergenerational relationships have become increasingly crucial for maintaining well-being in aging families. Under a changing sociocultural background, families in Hong Kong increasingly exhibit diverse intergenerational relationships and functioning. Focusing on families with mutiple children, this study investigated how the characteristics of parents and their adult children jointly affect different domains of intergenerational relationship quality. A two-stage stratified random sampling design was adopted. Face-to-face questionnaire interviews were conducted between November 2016 and March 2017 with 1,001 Hong Kong residents aged ≥ 50 years. Data of 612 parents and 1,745 adult children were included for analysis. Hierarchical linear modeling was performed to examine child- and parent-level correlates of intergenerational relationship quality. Parents who were female, were married, had higher self-perceived economic status, owned a house, and had fewer depressive symptoms, exhibited higher intergenerational relationship quality. Parents' age was positively related to affectual closeness, whereas their educational level was negatively related to both affectual closeness and conflict. More favorable intergenerational relationships were reported by aging parents whose adult children were younger, female, and married. Children with higher educational levels exhibited higher levels of both affectual closeness and conflict with their parents. Moreover, affectual closeness was found to be transmitted between generations. The findings can help improve awareness of the factors affecting the different domains of intergenerational relationships, thus informing the development of targeted services and interventions to promote family relationships and well-being.

The Effects of Multidimensional Poverty on Life Satisfaction Among Older Adults in Hong Kong

Poverty indicators such as income-based poverty, material deprivation, asset-based poverty, and expenditure-based poverty each carries an aspect of economic deprivation. This current study examined and compared the unique effects of each poverty dimension on life satisfaction during old age. We measured four poverty indicators—life satisfaction, social resources, physical health, and mental well-being—in a three-wave sample of older Hong Kong adults ( N = 563). Panel data were fitted to a structural model that involved the constraints of the path coefficients (e.g., effects of poverty indicators on life satisfaction). The model results indicate that while material deprivation and asset-based poverty reduce life satisfaction, income-based poverty and expenditure-based poverty do not significantly shape life satisfaction. Based on these findings, we suggest implementing future-oriented interventions into policy agendas to promote current working adults’ financial preparation for retirement to reduce their risk of falling into asset-based poverty and thus material deprivation after retirement.

Exploring nursing students' learning experiences and attitudes toward older persons in a gerontological nursing course using self-regulated online enquiry-based learning during the COVID-19 pandemic: A mixed-methods study

BACKGROUND

During the COVID-19 pandemic, universities adopted online teaching as the primary teaching and learning method. Most of the online teaching, however, has been limited to the broadcasting of asynchronous lectures and sharing of teaching materials.

OBJECTIVES

To explore undergraduate nursing students' self-regulated learning experiences, satisfaction, and attitudes toward older persons in a gerontological nursing course using online self-regulated enquiry-based learning (EBL) during the COVID-19 pandemic.

DESIGN

A mixed-methods design was adopted.

SETTING

A university in Hong Kong providing pre-registration nursing programmes.

PARTICIPANTS

155 students studying in the fourth year in a five-year Bachelor of Nursing programme participated in the quantitative study in which 18 joined the focus groups (4 groups with group size of 4-5).

METHODS

Five video-based scenarios along with two interactive online workshops, a mind-map development exercise, gamified assessments, reading materials, group discussions, and presentations were adopted in a gerontological nursing course offered in 2019-2020 to enhance the students' learning, driven by a process of enquiry. Attitudes toward older people were measured at baseline and one week after the course (post-test). Information on self-regulated learning experiences, satisfaction, and confidence were collected at post-test only. Paired t-tests and descriptive statistics were used to analyse the data. Focus groups were conducted through semi-structured interviews and transcribed verbatim for inductive content analysis.

RESULTS

A significant improvement was demonstrated in the students' attitude toward older people. The students appreciated the opportunities provided by the online EBL to apply key concepts of gerontology in the teaching and learning activities and to enhance their critical thinking skills. Three major themes were revealed from the focus group: Perception of the teaching pedagogy, Improvement of cognitive skills, and Positive and negative aspects of the learning experience.

CONCLUSIONS

The online self-regulated EBL improved the students' online learning experience in a gerontological nursing course during the pandemic and improved their attitudes toward older people.

Adaptation and Validation of the Preparation for Future Care Needs Scale for Chinese Older Adults in Hong Kong

Background and Objectives

Care planning can protect against or offset potential stressors in the caregiving stage and mitigate their detrimental effects. This study aimed to translate, adapt, and validate 2 short forms of the multidimensional, theory-guided scale measuring preparation for future care needs (PFCN) among Chinese older adults in Hong Kong.

Research Design and Methods

Data were derived from a cross-sectional survey of 862 community-dwelling individuals aged 60 years and older. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess the structural validity of the scales. Criterion-related validity, known-groups validity, and internal consistency were also examined.

Results

EFA yielded a 14-item 4-factor (awareness, avoidance, decision making, and concrete planning) model, which was supported by CFA and explained 68.9% of the total variance. CFA also supported the structural validity of the 5-item scale. Criterion-related validity of the 2 scales was supported by their significant and positive correlations with domain-specific planning behaviors for retirement. Known-groups validity of the 2 scales was demonstrated by significant differences in scores between male and female older adults and scores between different educational levels and socioeconomic status. Cronbach’s alphas for the internal consistency of the 14-item and 5-item scales were 0.889 and 0.774, respectively.

Discussion and Implications

PFCN scales enable researchers and service practitioners to accurately understand and assess older adults’ processes and efforts in care planning, facilitate the identification of individuals at risk from inadequate planning, and inform the development of interventions to enhance care preparation in target domains.

Cross-Border Medical Services for Hong Kong's Older Adults in Mainland China: The Implications of COVID-19 for the Future of Telemedicine

Cross-border services and support are becoming an increasingly important part of Hong Kong's social policy because an increasing number of its older citizens are choosing to live in mainland China. Unfortunately, with the recent outbreak of COVID-19, medical services for cross-border older adults have been blocked due to strict immigration controls. This article examines the effects of COVID-19 on these older adults, with a specific focus on the interruption of medical services and the remedial measures taken by the government and non-governmental organizations. It also discusses the prospect of delivering care for cross-border older people using telemedicine, which is considered one of the most important methods for overcoming space-distance and reducing the risk of cross-contamination caused by close contact.

Personal care expectations: Photovoices of Chinese ageing adults in Hong Kong

The increasing ageing population contributes to growing demands for personal care that fulfils ageing adults' preferences and expectations. This study explored Chinese ageing adults' expected forms and sources of future personal care and the factors influencing care expectations. A qualitative photovoice research method - which integrated photography, interviews and group discussions - was used for data collection between January and April 2016. Through purposive sampling, 36 community-residing participants aged 51-80 years took photographs that captured personal care preferences or expectations within individual, familial and societal contexts. Participants described feelings of worry, uncertainty and unpreparedness for future care needs and arrangements. They preferred practicing self-care for as long as possible and remaining in their homes and communities ("ageing in place") through support from assistive technologies, family members or home-based and community services. Institutional care was regarded as the last resort. The findings reflected discrepancies between ageing adults' care preferences and realities and their ambivalent attitudes towards filial care when switching between roles. Confronted with the increasingly unreliable family care, financial resources and insufficient community services, participants anticipated receiving institutional care that would be less satisfying or that they would dislike. As caregivers, ageing adults displayed strong commitment to filial obligations, whereas when perceiving themselves as care receivers they felt that they could not expect care from their children because of practical considerations. By understanding preferred care forms and sources, actors can devote resources, policies and interventions to support self-care through proactive planning and technological advancement, foster "ageing in place" through family and community care, and improve institutional care to enable ageing with dignity.

Employer Policy and Practice Toward Older Workers in Hong Kong: The Role of Shifting Intergenerational Dynamics

Many governments are seeking to encourage the extension of working lives to counteract potential labor market shortages that might result from population aging. Nevertheless, research shows that older workers continue to face a range of barriers to their labor market participation. However, this research has not tended to take a holistic view of the factors shaping employer policy and practice or acknowledge that older workers' experiences are embedded within broader social structures and age dynamics. This article reports on exploratory qualitative research undertaken in Hong Kong. It demonstrates how employer policy and practice toward older workers are shaped by intergenerational dynamics and by the social responsibility that employers feel toward different generations. It is argued that in order to more fully understand employer policy and practice toward older workers, an approach that acknowledges the social context and position of different age groups is required.

Whom should I rely on for my future care? Patterns of care expectations and intergenerational correlates among ageing Chinese adults in Hong Kong

This study examined ageing parents' care expectations across multiple care domains (financial and material, emotional, personal and informational) towards filial and formal sources and identified intergenerational correlates of care expectation patterns using a proposed care expectation model. Data of 780 eligible ageing parents were drawn from a representative household survey of ageing adults (≥50 years) conducted in 2016-2017. Latent class analysis was used to examine the typological structure underlying ageing parents' care expectations. Four patterns of care expectations were discovered: mixed-maximal, filial-modest, formal-modest and neither-minimal. Multinomial logistic regression analysis was conducted to validate the newly proposed care expectation model. In addition to certain predisposing factors (participants' age, sex and education), parental enabling resources (economic status), health characteristics (physical, mental and functional health status), children-related enabling characteristics (number of sons and marital status of children), and intergenerational enabling circumstances (intergenerational relationships and caregiving to their own parents) were introduced into the model and found to be associated with ageing parents' care expectations. The findings can inform policy and programmes that effectively respond to ageing adults' diverse care expectations in Hong Kong and have implications for other Asian societies facing rapid population ageing and increasing care demands.