Human resources in long-term care for older adults in China: Challenges amid population aging.

PurposeThe purpose of the present study was to investigate the current status of and factors influencing the demands for telenursing-based long-term care in disabled older adults.MethodsIn this cross-sectional study, data from 213 participants from five districts of Qingdao, China, were investigated using multistage stratified sampling. The assessment scale of the long-term care demands level and the questionnaire of the demands of telenursing-based long-term care for disabled older adults were used to estimate the demands for telenursing-based long-term care for older adults with disabilities in Qingdao.ResultsOf the participants, 60.51% were willing to receive telenursing-based long-term care. The item with the highest score was “Internet +” information management and first aid (3.77 ± 0.71); the item with the lowest score was “Internet +” daily care (2.97 ± 0.72). Average family income (P < 0.001), age (P = 0.004) and educational level (P = 0.003) were significant factors influencing the demands for telenursing-based long-term care.ConclusionDisabled older adults had a high demand for telenursing-based long-term care. Urgent actions are needed to integrate telenursing with long-term care as soon as possible. In the development of telenursing-based long-term care, it is necessary to fully consider the average family income, age and educational level of disabled older adults.

Objective: The objective of this study is to investigate the discourses of aging experiences for older adults in China, with the aim of gaining insight into understanding the older adults to provide better service for them in the realization of the sustainable development goals (SDG). Theoretical Framework: In this paper, the main concepts and theories that underpin the research are presented. Using social constructionism and life course theory as the theoretical framework, this study draws on the view that we construct certain realities and views of the world through the use of language, providing a solid basis for understanding the context of the investigation. Method: The study adopts a discourse analysis to investigate the older adults’ aging experience. Patterns of language across texts as well as the social and cultural contexts are examined in that the texts occur through the analysis of language in use. Data collection was carried out through semi-strctured focus group interviews. Results and Discussion: The findings revealed that the dominant discourse of older adults’ experience was concerned with the aging well and keeping healthy. The older adults in China talked about their aging perceptions based on maintaining a good mindset, regular diet and exercises, positive attitudes and healthy lifestyle. This positive discourse of aging showed that older adults were satisfied with their later life. This had close relationship with Chinese aging policy and current social circumstance for the older adults, which demonstrated that China has practiced the SDGs undoutedly. The older Chinese adults used positive discourse to show their positive attitudes towards aging which could be defined as new notion of positive aging. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how the results can be applied or influence practices in the field of discourse of aging. The application of existing theories and methodological approaches to discourse of aging and illness may also be of significant interest for other researchers. Originality/Value: This study contributes to the knowledge of discourse of older adults in China and gain more insights into aging population and facilitate understanding of aging for whole society.

The growth of the aging population has been accompanied throughout a rapid increase in the number of disabled people and the demand for long-term care (LTC) services. Shandong Province has the largest number of older adults in China. It is necessary to explore their preferences in LTC models and the related factors. In a cross-sectional study conducted in August 2017, 6997 older adults aged 60years and older were interviewed. Descriptive analysis, independent sample t tests, χ2 tests, and multinomial logistic regression were used to show preferences and the related factors in LTC models (family care, home- and community-based care (HCBS), and institutional care) based on the Andersen Behavior Model. Family care (89.1%) was the first preference for older adults and 8.2% chose institutional care, but only 2.7% chose HCBS. The logistic regression results indicated that older people aged 60-64years and those with a higher education level tended to choose HCBS or institutional care (P < 0.05); in the eastern region of Shandong Province, they tended to choose HCBS and institutional care over family care (P < 0.05). Older people with self-care limitations were more likely to choose HCBS (P < 0.05). Older adults with a stronger sense of loneliness were more likely to choose HCBS and institutional care (P < 0.05). The results can enable us to make tentative recommendations for older people, relevant decision-makers, and administrative bodies. Additionally, a more rigorous longitudinal design is necessary to investigate causality in regard to related factors and preference in LTC models.

Burden of cancer and changing cancer spectrum among older adults in China: Trends and projections to 2030

In developing countries aging is in many ways more difficult than in developed countries. In order simply to maintain the same standard of living as they age people must rely on pensions their savings and/or their children or other relatives. However few developing nations offer formal pension plans for rural residents. Nor can they live off of their savings; in developing countries they are generally poor and are not able to accumulate sufficient assets or saving during their lifetimes. Therefore villagers in developing countries typically rely on their extended family to support them in their old age. Life in rural China traditionally has been like rural life in many other developing countries as families have played an important role in maintaining the elderlys livelihood. As in time past this still primarily means reliance on the support of sons. In a typical situation the elderly in rural China live with or next door to one of their sons in an extended family arrangement. (excerpt)

Prevalence of depressive symptoms among older adults in mainland China: A systematic review and meta-analysis

Introduction. Population aging has generated an increase in the demand for long-term care, often assumed by informal caregivers, who face multiple physical, emotional, and social challenges. Their experience is key to improving care for older adults. Objective. To determine the perceptions of non-professional caregivers of older adults in a public hospital in Peru, in relation to the geriatric care received and their role in comprehensive patient care. Methods. A cross-sectional descriptive study was conducted among caregivers of geriatric patients at the Edgardo Rebagliati Martins National Hospital during November and December 2024. The validated IEXPAC 2018 questionnaire was administered to a convenience sample of non-professional caregivers of older adults cared for in the previous six months. Results. A total of 120 caregivers participated, with a mean age of 48.6 and a standard deviation of 12 years. Ninety-five percent were women. The items with the highest positive ratings were: "knowing who to contact in the emergency room" and "information to better care for the patient," both with over 85%. Approximately 70% highlighted positive aspects of the home geriatric care service, such as adherence to treatment plans, medication safety, and promotion of healthy habits. Ninety-nine percent considered it urgent to implement a specialized geriatric service, and 90% requested weekly care for their patients. Conclusions. Although caregivers perceive adequate treatment from healthcare personnel, they identify a marked inadequacy in the provision of specialized geriatric services. This gap highlights a structural challenge for the Peruvian healthcare system in providing comprehensive care to older adults.

The dual demographic changes in massive rural-to-urban labour migration and population ageing have significantly impacted the lives of older adults, who have either been left behind in rural regions or migrated to urban areas. While many extant studies on migration and wellbeing of older adults have focused on either migrating or left-behind older adults, a very limited number of studies have directly compared these two groups. Utilising data from the China Longitudinal Ageing Social Survey, this study examines the impacts of different migration patterns (i.e.migrating older adults, left-behind older adults and non-migrating older adults) on the social networks and mental health of older adults in rural China. Structural equation modelling results showed that older adults who have been left behind reported weaker family ties and poorer mental health than the other older adults. Moreover, weakened family ties increased older adults’ risk of developing mental health problems. Older migrants reported the lowest level of depressive symptoms among the three groups of older adults. However, migration may be associated with poorer mental health among the older migrants due to the shrinking/weakening of family/friendship ties.

As the population of older adults is estimated to double by 2050, the growing demand for nurses to provide care to older adults will grow. Internationally, attitudes among nursing students towards caring for older adults range from negative to slightly positive. The purpose of this qualitative descriptive study was to examine undergraduate nursing students' thoughts, feelings and perspectives towards older adults residing in nursing homes prior to their clinical experience. Students enrolled in a clinical component of a course within a baccalaureate nursing programme were prompted to write a one-page reflection on their thoughts and feelings toward caring for older adults in a nursing home. Artefacts from 72 undergraduate students' were examined, and data saturation was obtained at 20 cases. Utilizing a one-time inquiry approach, we identified eight categories that emerged from the data: Range of emotions when anticipating clinical, building rewarding relationships with older adults, preparing for my nursing career, student pre-existing attitudes, providing the best care possible, relationships with grandparents, experience(s) in nursing homes and older adults 'have so much to teach us'. Two themes encompassed all the others: '[Older adults] have so much to teach us' and 'providing the best care possible'. A strong majority of students expressed enthusiasm for their upcoming clinical in a nursing home. Students' attitudes were significantly more positive than those in prior studies. The results offer essential insight for nursing faculty who teach and design clinical experiences for undergraduate nursing students in nursing home facilities. Faculty should take account of their students' prior experiences, thoughts, and feelings to prepare them appropriately to care for older adults in their future nursing careers. Increasing staffing and retention of staff in nursing homes facilities remains a priority for stakeholders in long-term care of older adults. Nursing educators must continuously assess students' knowledge and attitudes assists to identify knowledge gaps and misconceptions, which must be addressed to teach student nurses how to provide high-quality, effective and culturally sensitive care to older adults. As students become more competent in caring for older adults, their desire to pursue a nursing career in gerontology care may increase. Early experiences of student nurses with older adults will prepare nursing students for their future career. Understanding students' thoughts and feelings will assist faculty in tailoring clinical orientation, designing clinical experiences and post-conference debriefings that address students' concerns. This research contributes to the knowledge of perceptions of nursing students and will assist to design educational experiences. Nursing educators who understand nursing students' attitudes toward caring for older persons can facilitate therapeutic interactions between nursing students and older adults. Designing experiences with these research results in mind may facilitate the development of positive attitudes towards caring for older adults.

Prevalence and socio-demographic characteristics of disability in older adults in China: Findings from China Comprehensive Geriatric Assessment Study

The current cross-sectional study aimed to investigate social connection and lifestyle factors associated with happiness in urban older adults in mainland China. A total of 709 community-dwelling older adults aged 60 to 99 years completed a comprehensive survey covering demographics, happiness, cognition, lifestyle, sleep, nutrition, and social connections. Samples were divided by age into two groups for analysis: young-old (aged 60 to 69 years) and old-old (aged 70 to 99 years). Social connection factors, including relationships with friends and spouse and use of social media applications, were important predictors for happiness in people in their 60s. Lifestyle factors, including nutritional status and extent of physical activity, were associated with happiness in old-old adults. Sleep quality predicted happiness for both age groups. Living with children and happiness were not significant for either age group. Results suggest that social connection and lifestyle are important factors in promoting happy and healthy successful aging in urban older adults in China. [Research in Gerontological Nursing, 16(3), 147-160.].

Childhood family risks (CFRs) are believed to have long-arm effects on people's mental health. However, it is unclear whether age can alleviate these long-arm effects. This study aimed to explore the relationship between CFRs and the mental health of older adults (mean [M] = 62.10, standard deviation [SD] = 8.02) in China and investigate whether age could moderate this relationship. This cross-sectional, survey-based study used data from the Chinese General Social Survey conducted in 2015, and the data of 4,237 respondents were included in the final analysis. Mental health was measured by two items, namely negative and positive emotions. The step-by-step regression procedure and moderation analysis technique were used. For older adults in China, CFRs were significantly negatively associated with their mental health (β = -0.046, t = -2.690, p < 0.01), age was positively correlated with their mental health (β = 0.115, t = 7.157, p < 0.01), and age significantly moderated the relationship between CFRs and mental health (β = 0.277, t = 2.172, p < 0.05). As age increases, the correlation between CFRs and mental health decreases, and when age is one SD above the M, CFRs are no longer significantly associated with the mental health level (b simple = -0.01, t = -0.077, p > 0.05). This study showed that CFRs were negatively associated with the mental health level of older Chinese adults, and age could significantly moderate the association. Therefore, it is essential to take preventive measures in advance to protect people's mental health and teach older adults to use emotion-regulation techniques to weaken the association between CFRs and mental health.

Background: Pain status is a common concern among older adults and has been linked to functional limitations. This study aimed to examine the association between pain status and disabilities risk in basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in older adults in China, using data from the 2020 China Health and Retirement Longitudinal Study (CHARLS).Methods: A cross-sectional analysis was conducted using data from 8102 participants aged 60 and older from the 2020 CHARLS. Univariate and multivariate binary logistic regression analyses were performed to assess the association between pain status and BADL/IADL disabilities. We further examined the contribution of each covariate and categorized participants by pain location and number of pain sites. Subgroup analyses were conducted to examine the consistency of findings across demographic and health-related factors.Results: Pain status was significantly associated with higher odds of both BADL and IADL disabilities (p < 0.05), even after adjusting for covariates. Self-rated health and depressive symptoms exerted the greatest influence on the OR values. Pain in any anatomical region, particularly when present at multiple sites, was associated with increased odds of disability. Head and neck pain was specifically associated with IADL disability, while pain in the upper limbs, torso, and lower limbs was associated with both BADL and IADL disabilities. Subgroup analyses confirmed the robustness of these associations.Conclusions: Pain status, especially multisite pain, is significantly associated with BADL and IADL disabilities in older Chinese adults. Although causality cannot be inferred due to the study's cross-sectional design, these findings underscore the importance of addressing pain alongside other health and psychological factors when developing strategies to support functional independence in aging populations.

Social welfare utilization and needs of older adults in Taiwan: Survey research

As the population ages, understanding the association between sleep patterns and physical frailty in older adults is crucial for formulating effective health interventions. This study aimed to explore the relationship among nap time, nighttime sleep duration, and physical frailty in older Chinese individuals; establish recommended sleep times; and provide a scientific and reasonable basis for the prevention and management of frailty in older adults. On the basis of the 2020 China Health and Retirement Longitudinal Study database, demographic information, health data, and lifestyle information of the research subjects were obtained. A total of 5,761 survey participants were included, and logistic regression and restricted cubic splines were used to explore the association between sleep duration and frailty. In our cross-sectional analysis, the duration of napping in older adults did not show a significant correlation with frailty. The optimal nighttime sleep interval for older adults was 7-8 h, and the maximum health benefit was achieved when nighttime sleep reached 7.5 h. Compared with older adults in China who slept 6-8 h at night, those with a sleep duration of <6 h (OR = 1.58, 95% CI: 1.36-1.82) were more likely to be frail. After adjusting for all covariates such as smoking, multimorbidity, self-rated health, social events, education level, and frequency of physical activity, we found no interaction between gender and age concerning sleep duration. The potential correlation between nighttime sleep duration and frailty in older adults is basically U-shaped. Older Chinese adults with a moderate nighttime sleep duration of 7-8 h exhibited the lowest likelihood of frailty than their counterparts. The duration of napping is not related to the likelihood of frailty in older people. Thus, the importance of sufficient nighttime sleep for the health of older adults must be emphasized.