“Long illness, no filial children?” Offsprings' care for older adults with disabilities in China

Abstract

Objective

This study examines whether the proverb “long illness, no filial children” still holds in contemporary China by assessing the effects of caregiving duration and intensity on offsprings' caregiving performance for disabled older adults.

Background

China's aging population and rising disability rates impose heavy caregiving burdens on families. Although filial piety strongly influences children's caregiving responsibilities, whether prolonged care truly erodes caregiving performance remains unclear.

Method

Drawing on 2011–2018 panel data from the China Longitudinal Healthy Longevity Survey (N = 2,047), this study focuses on older adults needing assistance with at least one activity of daily living and receiving care primarily from an adult child. Random-effects models examine how caregiving duration and intensity relate to offsprings' caregiving performance.

Results

High-intensity caregiving significantly diminishes offsprings' reported caregiving performance, whereas caregiving duration alone shows no significant effect. Subgroup analyses (gender, urban/rural residence, financial situation) confirm that heavier caregiving intensity predict lower caregiving performance across diverse contexts.

Implications

Policies that alleviate high-intensity caregiving—such as financial assistance, respite services, and community-based support—may improve care for disabled older adults and better sustain filial caregiving commitments.

Conclusion

These findings indicate that intensity rather than duration largely explains declines in caregiving performance, offering partial support for the proverb under modern conditions.