Intergenerational Support and the Experience of the Elderly at the End of Life: An Extension of a Longitudinal Study in Rural China

This study adopted a life course perspective in order to determine what  motivates and sustains intergenerational support, and how this support  influences older adults’ experience at the end of their lives. The researchers used death survey data from a five-wave longitudinal survey over the past 12 years conducted in rural areas of Anhui province, and pooled the death samples from each wave. Multi-level linear models revealed that the level of the care provided by adult children is affected by their birth order, the physical distance from parents, and the level of intergenerational exchange before death.

The study also found gender differences in the children’s end-of-life care of their parents. The level of care provided by sons and their spouses is much higher than by daughters. Thus, even under the background of weakening of filial piety as a core social value, child’s care of their parents is still driven by the traditional "filial piety and fraternal duty" norms. Children's birth order is an important influence on parents’ and children's filial expectation and behavior. The oldest son or daughter plays a leading role relative to other siblings and take the responsibility at parents’ end of life, which conforms to the culture of Confucianism according to which "the eldest brother is like father, the eldest sister is like mother".  It seems that the negative influence of the sharp decline in fertility on dying elderly parents is not as bad as might have been expected. Our results suggest that responsibilities for parents can be undertaken by an only child or the eldest child in multi-children families.

The researchers also found that the motivation of adult children to provide end-of-life support to their older parents is partially rooted in earlier family experiences and guided by an implicit social contract that ensures long-term reciprocity. Children tend to provide more end-of-life care to parents who previously provided them with child care or financial resources. This confirms that older parents have maintained or even strengthened an intergenerational old-age support contract through selectively helping one or more children.

Our results also imply that even during the critical period at the end of a parent’s life, the mechanism of children’s labor division still conforms to the strategic allocation of resources throughout the family system. Geographic proximity to older parents is an important correlate with extent of end-of-life care. With recent social changes, informal end-of-life care is facing serious challenges.

A manuscript is in preparation.