Support In Later Life Research Articles

Older People Living Alone and Their Strategies to Face Life: Case Studies from Yogyakarta and West Sumatra

Across Indonesia, the dominant model for care and support in later life is for older people to live with or near younger family members. However, coresidence with an adult child or other close relative is not always attainable or preferred. There are conditions where older people live alone and cannot fully depend on their family members for care and support, be it for matters related to physical, economic, psychological, or spiritual needs. We examine how older people who live alone, live their lives and what strategies they pursue in facing life. The data presented in this paper are a subset of a larger comparative study on Older People’s Care Networks, which covered five disparate sites across Indonesia. This article focuses on evidence from West Sumatra and Yogyakarta. As our case studies illustrate, older people living alone is a diverse category, ranging from those with children, to those who are de facto childless or actually childless. Their security or vulnerability cannot simply be deduced from their household composition, but they require the understanding of how people create, maintain, and develop supportive networks and how they use agency in actively managing dependence, independence, and interdependence over the life course and in later life.

Intimate networks of care: Perceptions of intergenerational family care and experiences of ageing among Chinese midlife and older lesbians and gay men.

This article examines how lesbians and gay men imagine and build their 'intimate networks of care' and negotiate moral expectations towards intergenerational family care as they age. To date, little is known about the strength and complexities of different intimate ties or the role of intergenerational dynamics in shaping ageing sexual minority people's care needs and choices. Based on narrative interviews with ageing Chinese lesbians and gay men, the findings reveal their experiences of constantly juggling their ties with families of origin, moral values around intergenerational care and the urge to receive support from and offer support to chosen networks of people. Participants exercised agency in expanding their networks of care by building friendship and (online and offline) community networks for mutual care and support in later life. Nevertheless, as evidenced by the centrality of ageing with(out) children, and the moral obligation of caring for parents in participants' narratives, participants experienced tensions between enacting what was considered morally right/wrong and developing networks of care that were perceived as emotionally intimate. Linking relational sociology with the sociology of morality, we discuss the conceptual utility of 'intimate networks of care' for sociological theorising of the linkages between sexuality, care and relational lives.

The Impacts of Spirituality and Religious Participation on the Emotional Well-Being of Widowed Older Adults in Southeast Nigeria.

The population of older individuals in Africa is increasing, and at a rapid rate. Although the numbers of these individuals increase, many African countries, including Nigeria, are devoid of state-sponsored welfare systems that address their well-being. This situation has placed the bulk of support on the family members including spouses. Studies have shown that spouses are considered to be veritable sources of support in later life. However, spousal death tends to reduce the perceived support including emotional support, which usually occasions lower well-being, life dissatisfaction, and higher mortality rates. This study ascertains the impact of spirituality/religious participation on the emotional well-being of widowed older adults. The study was conducted in Enugu State, southeast Nigeria. The study implemented a qualitative approach to collect data from 71 widowed older adults, aged 60 and older. The thematic analytical method was used to analyze the generated data. Participating in spiritual/religious activities like prayers, church programs/activities reading, studying, and meditating on the word of God have enabled the widowed older adults to buffer some of the emotional challenges. Older adults should be encouraged to participate in spiritual and religious activities. Religious leaders should also make every effort to organize activities that will address the emotional needs of these individuals.

The association of women's experience of abuse in childhood with depression during pregnancy and the role of emotional support as a moderator.

This study aimed to examine the prevalence of antenatal depression and experience of abuse during childhood, to analyze the association between having experienced childhood abuse and depression during pregnancy, and to explore the role of emotional support as a moderator of that association. In total, 44,770 pregnant women were analyzed from the self-administered registry for risk assessment at community public health centers in Seoul, Republic of Korea, for home visiting service provision between 2015 and 2019. The Edinburgh Postnatal Depression Scale (EPDS) was applied for the assessment of depression. The adjusted effects of childhood abuse experience on antepartum depression according to emotional support as an effect moderator were estimated. Depression was present in 2,451 pregnant women (5.5%), and 1,506 (3.4%) reported having experienced physical, emotional, or sexual abuse in childhood. After adjustment of covariates, pregnant women who had experienced abuse during childhood had EPDS scores 2.79 points higher than pregnant women without such experiences, and those who lacked emotional support during adulthood had 4.96 points higher than their counterparts. The difference in EPDS scores based on childhood abuse experience among women who reported emotional support (2.86) was larger than the difference in EPDS scores among those with no emotional support (1.91) (P for interaction = 0.0106). The experience of abuse in early life and emotional support in later life are both independently important for understanding antenatal depression in Korean women. More comprehensive emotional support is needed for pregnant women who experienced abuse in childhood.

Social support network factors associated with verbal fluency among vulnerable persons living with HIV

ABSTRACT Vulnerable persons living with HIV (PLWH) are at high risk of cognitive impairment and challenges accessing quality social support in later life. Impaired verbal fluency (VF), a cognitive domain linked to HIV, could impede social support associated with health and well-being for already vulnerable PLWH. We examined the structure of social support, using latent class analysis, and the associations among quantity, specific forms and quality of social support and VF among PLWH. Participants enrolled in the BEACON study (n = 383) completed the Controlled Oral Word Association test (COWAT) and a social support network inventory. Latent class analysis with count variables was used to determine the number of classes of PLWH based on their social network characteristics. The majority of PLWH were male (61.4%) and African American (85.9%). Two distinct latent classes, with a major distinction in the number of network members who were female, knew participants’ HIV status and HIV medication usage. Fewer support network members (β = -.13, p < 0.01), greater negative interactions (β = -.16, p < 0.01), and less positive interactions with network members (β = .15, p < 0.05) were significantly associated with lower COWAT scores. Comprehensive screening of high-risk PLWH and early intervention with those with cognitive impairment are important for addressing social support needs.

The Reciprocal Relationship of Self-Rated Health and Instrumental Help From Adult Children: Evidence From Germany.

Receiving support from adult children may promote or be harmful for older adults' health. Poor health, however, often precedes the need for intergenerational support. To date, few studies have addressed the relationship between instrumental help (i.e., help with household chores) and older adults' self-rated health (SRH) simultaneously, thereby accounting for potential reverse causality. Moreover, little research has accounted for omitted variable bias. Dynamic panel models with fixed effects provide an opportunity to address these methodological issues. Drawing on four waves of the German Ageing Survey, which provide a sample of 3,914 parents aged 40-95 years, I investigate the bidirectional linkages between instrumental help from adult children and SRH. Results suggest that prior receipt of instrumental help is not a significant predictor of future reported SRH. Similarly, previous SRH does not significantly predict the likelihood of receiving instrumental help at follow-up. Instead, earlier values of SRH and instrumental help are most important for predicting future SRH and instrumental help. The results shed new light on the interplay between SRH and instrumental help from adult children. The study suggests that older adults' health and support in later life are not interdependent. I discuss these findings in relation to future policies for healthy aging to focus on interventions that facilitate optimal health in the earlier stages of the life course and for adult children to provide continued support to their parents.

THE MORE THINGS CHANGE, THE MORE THEY STAY THE SAME: CHANGE AND CONTINUITY IN ENDURING SOCIAL TIES

Abstract Enduring social ties with family and friends hold important implications for health and well-being across adulthood. Social relationships are simultaneously sources of support and strain, and both positive and negative aspects of relationships change daily and over time. This symposium explores continuity and change in relationship strains (i.e., conflicts, support needs) experienced in the context of enduring social relationships, particularly in response to anticipated and emerging needs for support in later life. First, Meinertz, Gilligan, and Suitor use qualitative data from spousal dyads to compare mothers’ and fathers’ explanations of which adult child they prefer as their future caregiver. Next, using longitudinal data across two waves, Bui, Kim, and Fingerman investigate how different types of past support exchanges between parents and adult children are associated with older parents’ care receipt and expectations. Third, Koumoutzis, Cichy, and Kinney explore the association between change in parental disability and adult children’s intergenerational ambivalence (i.e., both positive and negative sentiments), including the extent to which adult children’s stress and reward appraisals mediate the link between parental disability and ambivalence. Kyungmin and colleagues explore how older adults (age 62-76) felt burden in their relationship with their very old parents (age 81-101) and what factors are associated with feelings of burden across two cultural contexts, the U.S. and Korea. Lastly, using ecological momentary assessment, Birditt and colleagues examine longitudinal trajectories of negative ties (i.e., irritating, demanding) and the links between daily positive and negative social interactions and emotional well-being.

Occupational social class differences in the impact of COVID-19 related employment disruptions on retirement planning amongst older workers in England

Purpose This paper aims to examine the impact of COVID-19 related employment disruption on individuals’ retirement planning and whether these experiences differ by occupational social class. Design/methodology/approach To explore these issues, this study linked data from those who were employed in wave 9 of the English Longitudinal Study of Ageing (ELSA) main study with wave 1 of the ELSA COVID-19 study (N = 1,797). Multinominal regression analyses were conducted to explore whether the interaction between employment disruption and occupational social class was associated with planning to retire earlier or later than previously planned. Findings The results show that stopping work because of COVID-19 is associated with planning to retire earlier. However, there were no statistically significant interactions between occupational social class and employment disruptions on whether respondents planned to retire earlier or later. Originality/value This paper’s original contribution is in showing that the pandemic has had an impact on retirement decisions. Given the known negative effects of both involuntary early labour market exit, the findings suggest that the COVID-19 related employment disruptions are likely to exacerbate social inequalities in health, well-being in later life and, consequently, can help anticipate where there will be need for additional support in later life.

Complementary support in later life: investigating the gender disparities in patterns and determinants among older adults in South-Western Nigeria

Old-age needs are multifaceted and require multiple support sources, yet caregiving roles for older Nigerians are largely shifted to adult children. However, the children also declining capacity to respond. The extent to which older adults access support from other sources remains under-researched. This study investigates the patterns and determinants of access to complementary supports among older adults in South-Western Nigeria, taking Oyo State as the case study. The study is cross-sectional and utilized primary data of 827 older adults aged ≥ 65 years selected using a multi-stage sampling design. Box plot was used to determine the patterns while multiple ordinary least square regression was used to predict the determinants of access to complementary support. Expressed in percentage, the median complementary support score of older adults in Oyo State was 30 (interquartile range [IQR] = 24) with a slightly higher score for men (median = 32, IQR = 24) compared to women (median = 28, IQR = 20). Access to complementary support was lower for the widow(er)s, the lower socioeconomic group and self-dependent older adults across genders, and for urban women with secondary/higher education compared to the otherwise groups. Increased access to complementary support was significantly associated with primary/no education (β = 4.365; p < 0.01 95% C.I. = 1.511–7.218), affiliation to Islamic/Traditional religion (β = 5.100; p < 0.001; 95% C.I. = 3.000–7.200), rich wealth status (β = 3.315; p < 0.05; 95% C.I. = 0.667–5.963) and depending on both self and children/family for income (β = 5.510; p < 0.05; 95% C.I. = 1.710–9.309) with some gender disparities. However, reduced complementary support was associated with ages 80 years or over (β = -3.649; p < 0.05; 95% C.I. = -6.460 – -0.838) and widowhood (β = -6.285; p < 0.001; 95% C.I. = -8.556 – -4.015). The study suggests the need for welfare plans among professional, social, and religious groups, institutionalised social support systems, and community engagement to escalate welfare support for older adults. It also recommends intensified attention on the more vulnerable groups, especially the widows, childless and lower socioeconomic groups.

Loneliness among older adults in Europe: The relative importance of early and later life conditions.

The aim of this paper is to study the association between childhood circumstances and loneliness in older adults in Europe. Based on rich information collected by the Survey on Health, Ageing, and Retirement in Europe (SHARE) on childhood characteristics and individual characteristics at age 50+, the study is able to control for personality traits, socioeconomic and demographic factors, social support and health in later life, and country-specific characteristics. The analyses show strong correlations between life circumstances in childhood and feeling lonely in older age; these correlations remain significant after adjusting for covariates. While ill health is the main factor correlated with loneliness at 50+, as expected, the analysis of the relative importance of the determinants reveals that personality traits account for more than 10% of the explained variance and that life circumstances during childhood account for 7%. Social support at older ages is the second highest category of factors, accounting for 27%—with, interestingly, support at home and social network characteristics contributing about 10% each, engaging in activities and computer skills accounting for 7% of the explained variance. Demographic and socioeconomic factors account for 6% and country-level characteristics contribute 5%. This paper points out the relevance of early life interventions to tackling loneliness in older age, and it shows that early interventions and interventions aiming at increasing social support in later life need to be adapted to all personality types. Thus, the role of childhood circumstances and the mechanisms explaining the association between loneliness in childhood and loneliness in later life deserve more attention in future research.

Childhood hearing impairment and fertility in Norway

There is a lack of studies assessing how hearing impairment relates to reproductive outcomes. We examined whether childhood hearing impairment (HI) affects reproductive patterns based on longitudinal Norwegian population level data for birth cohorts 1940–1980. We used Poisson regression to estimate the association between the number of children ever born and HI. The association with childlessness is estimated by a logit model. As a robustness check, we also estimated family fixed effects Poisson and logit models. Hearing was assessed at ages 7, 10 and 13, and reproduction was observed at adult ages until 2014. Air conduction hearing threshold levels were obtained by pure-tone audiometry at eight frequencies from 0.25 to 8 kHz. Fertility data were collected from Norwegian administrative registers. The combined dataset size was N = 50,022. Our analyses reveal that HI in childhood is associated with lower fertility in adulthood, especially for men. The proportion of childless individuals among those with childhood HI was almost twice as large as that of individuals with normal childhood hearing (20.8% vs. 10.7%). The negative association is robust to the inclusion of family fixed effects in the model that allow to control for the unobserved heterogeneity that are shared between siblings, including factors related to the upbringing and parent characteristics. Less family support in later life could add to the health challenges faced by those with HI. More attention should be given to how fertility relates to HI.

Loneliness, Social Support, and Psychological Wellbeing Among Older Adults

Social support in old age has been linked to psychological wellbeing outcomes, such as depressive symptoms. However, insufficient attention has been paid to implications of social support for different domains of psychological wellbeing. In this study, we explored these associations among 797 older adults (mean age = 78.61 years) living in a retirement community in Florida from the ECRC study. Our findings show that measures of social support and connectedness have varying influences on psychological wellbeing. Loneliness was associated with lower life satisfaction (b=- -1.12, p<0.001) and higher depressive symptoms (b=3.52, p<0.001). Higher self-rated social support was associated with higher life satisfaction (b= 1.66, p<0.001) but did not predict depressive symptoms. Depressive symptoms, however, were significantly higher (b=-1.45) among individuals who reported that they don’t have anyone who they can turn to if they feel lonely and want to talk. Feeling lonely also predicted lower positive affects among these older adults (b=-0.65, p<0.001). Similarly, loneliness also predicted higher negative affects (b=1.28, p<0.001). Negative affects were also significantly higher among women (b=-1.15, p<0.001) but lower among those who were living alone (b=-1.06, p<0.001). Overall, our findings underscore the importance of social support and connectedness for psychological wellbeing in later life. This finding is consistent with prior research demonstrating significance of social support in later life for the overall psychological wellbeing of the older adults.

Aging Without Children: The Link between Parental Status and Tangible Support

Having children is a potential resource for care and support in later life. However, whether and, if so, under what conditions, childless older individuals risk insufficient support remains unclear. Using the Danish Longitudinal Study of Ageing (2017), restricted to respondents aged 67 years to 97 years ( n = 5,006), our study analyzes the link between availability of tangible support and parental status in a Nordic welfare state. Our results confirm a negative link between childlessness and support mainly among unpartnered individuals. This combined disadvantage is stronger among men than among women, and the support gap intensifies with increased health needs. Taken together, although childlessness in itself is no major disadvantage for support in late life, childless men living alone risk insufficient support, particularly when in poor health. Our findings have important policy implications for future cohorts of older individuals, who will have less access to support from either a spouse or children.

Comparing the Protective Value of Human and Pet Social Support on Well-Being of Older Adults During COVID-19

Older adults are vulnerable to particular risk factors that contribute to lower well-being and poorer functioning. With the COVID-19 pandemic, the importance of social support has been highlighted in media reports because of its well-known beneficial effects on overall well-being. However, as adults age, social networks, contacts, and activities naturally decrease. These age-related losses are often difficult, if not impossible, to replace. Pets have recently been recognized as a valuable source of social support for many older adults, providing both physical and psychological benefits through mutual connection and behavioral activation. Previous studies have examined how human social support or pet social support enhance older adults’ well-being (i.e., positive emotions, engagement, relationships, accomplishment, and meaning). However, there is a gap in our scientific knowledge as previous research has not evaluated if pet social support can serve as a protective factor in the absence of adequate human social support. Current analyses, with 141 older adult participants, suggests that pet owners with a positive attachment to their pet experience higher well-being as pets serve as a coping resource that protects against common life stressors. Similar to human social support, pet social support appears to be a protective factor that also promotes and fosters a sense of well-being in older adults. Support in late life is especially important for families and agencies to be attuned to, especially during a global pandemic.

Do Social Support and Strain Mediate the Relationship Between Childhood Exposures and Frailty in Later Life?

Previous studies have identified the early origins of physical frailty, notably poor childhood health and socioeconomic status, but relatively few studies examine whether social support in later life mitigates the influence of early noxious exposures on frailty. Given the established relationship between health and social relationships in older adults, this research uses data from the Health and Retirement study (2004-2016) to examine whether social support and strain mediate the effect of childhood exposures on frailty in later life. A series of linear regression and pathway models were estimated to test whether childhood exposures, including socioeconomic status, infectious and chronic diseases, impairments, and risky adolescent parental behaviors, were associated with phenotypic frailty (Fried et al. 2001). After adjusting for demographic and adult factors, accumulated childhood misfortune was directly (b=0.015, p<.01) and indirectly (b=0.007, p<.001) associated with more frailty. Average social support, but not strain, from one’s spouse, children, family and friends significantly mediated the relationship between accumulated misfortune and frailty (b= -.002, p<.01). Path analysis revealed that social support reduces later life frailty directly (b=-0.106 ,p<.001) and indirectly through a reduction in adult morbidity (b=-0.031, p<.001). However, counterintuitively we found that accumulated misfortune was associated with more social support. Supplemental analyses reveal that one or more infectious diseases in childhood were responsible for the positive relationship (b= 0.393, p<.001). These results have implications for how we may reduce the burden of frailty on those who have experienced misfortune early in life.

Does spatial proximity supplant family ties? Exploring the role of neighborly support for older people in diverse, aging cities

ABSTRACT The aging population, coupled with increasing diversification, is currently altering the social fabric of cities worldwide. At the local level, social ties within a neighborhood play a key role in enabling older people to age in familiar surroundings. However, family ties in the neighborhood become less common implying that older people become more dependent on alternative support systems such as friends and neighbors. Drawing from a mixed-method research in Berlin (Germany), focus group discussions (26 participants) and survey data (n= 506), we explore the scope of neighborhood support in later life. Our qualitative findings suggest that women, migrants, and people without families close by primarily provide support to fellow older people. Findings from ordinal regression analysis support this on a larger scale. We conclude that these findings point to a new meaning of spatial proximity for social support in times of weakened family ties and growing diversity in old age.

Attitudes and preferences towards future old-age support amongst tomorrow’s elders in China

The life course experiences of those born in China from the late 1950s to early 1970s have been very different to those of their predecessors; they may not be able to, or wish to, rely on their family for support in later life in the future.

Is having more children beneficial for mothers’ mental health in later life? Causal evidence from the national health and aging trends study

Objectives Members of the baby boom cohorts had fewer children than their parents. Given that adult children are an important source of social support in later life, this may have implications for the mental health of new cohorts of older people. This study investigates whether having additional children protects white mothers aged 65 and older against mental health problems. Method Data are from Wave 1 and Wave 5 of the National Health and Aging Trends Study (n = 3,845). An instrumental variable approach exploiting the preference for mixed-sex offspring is used to estimate the causal effect of additional children on the risk of elevated depression and anxiety symptomatology. Results The estimated instrumental variable model shows that additional children reduce the risk of suboptimal mental health among white mothers aged 65 and older. Conclusion Results suggest that declines in higher-order births may put new cohorts of older women at increased risk of suboptimal mental health.

Changing family structures and self-rated health of India's older population (1995-96 to 2014).

A common view within academia and Indian society is that older Indians are cared for by their families less than in the past. Children are a key source of support in later life and alternatives are limited, therefore declining fertility appears to corroborate this. However, the situation may be more complex. Having many children may be physiologically burdensome for women, sons and daughters have distinct care roles, social trends could affect support provision, and spouses also provide support. We assessed whether the changing structure of families has negatively affected health of the older population using three cross-sectional and nationally representative surveys of India's 60-plus population (1995–96, 2004 and 2014). We described changes in self-rated health and family structure (number of children, sons, and daughters, and marital status) and, using ordinal regression modelling, determined the association between family structure and self-rated health, stratified by survey year and gender. Our results indicate that family structure changes that occurred between 1995-96 and 2014 were largely associated with better health. Though family sizes declined, there were no health gains from having more than two children. In fact, having many children (particularly daughters) was associated with worse health for both men and women. There was some evidence that being sonless or childless was associated with worse health, but it remained rare to not have a son or child. Being currently married was associated with better health and became more common over the inter-survey period. Although our results suggest that demographic trends have not adversely affected health of the older population thus far, we propose that the largest changes in family structure are yet to come. The support available in coming years (and potential health impact) will rely on flexibility of the current system.

Cognitive reappraisal and the association between depressive symptoms and perceived social support among older adults

Objectives There is an association between depression and diminished social support; indeed, interpersonal dysfunction is often a central feature of depression. The purpose of this study is to examine the role that an emotion regulation (ER) strategy, cognitive reappraisal, plays in influencing the association between depressive symptoms and perceived social support in older adults. Method Data for this cross-sectional study come from a community-based survey of older adults (60+, N = 910). We examined the effects of depressive symptoms and cognitive reappraisal on perceived social support. We then examined the potential moderating role of cognitive reappraisal on the association between depressive symptoms and perceived social support. Results Depressive symptoms were associated with lower levels of perceived social support. Cognitive reappraisal was associated with higher levels of perceived social support. Cognitive reappraisal moderated the negative consequences of depressive symptoms on perceived social support. Whereas depressive symptoms had a negative effect on perceived social support, the negative effect was greater for those with lower levels of cognitive reappraisal compared to those with higher levels of cognitive reappraisal. Discussion ER strategies may play a role in attenuating the negative consequences of depressive symptoms on social support in older age. It may be possible to help individuals maintain social support in later life, even in the face of mental health challenges, if they cultivate ER skills.