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Social support and care arrangements of older people living alone in rural Malaysia

Published online by Cambridge University Press:  09 May 2017

NATALIE EVANS ,
PASCALE ALLOTEY ,
JOANNA D. IMELDA ,
DANIEL D. REIDPATH  and
ROBERT POOL
NATALIE EVANS*
Affiliation:
South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia. Centre for Social Science and Global Health, University of Amsterdam, The Netherlands. Department of Public and Occupational Health, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.
PASCALE ALLOTEY
Affiliation:
South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia. Global Public Health, School of Medicine and Health Sciences, Monash University, Sunway campus, Jalan Lagoon Selatan, Malaysia.
JOANNA D. IMELDA
Affiliation:
South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia. Centre for Social Science and Global Health, University of Amsterdam, The Netherlands. Department of Social Welfare, Faculty of Social and Political Sciences, University of Indonesia, Depok campus, Depok, Indonesia.
DANIEL D. REIDPATH
Affiliation:
South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia. Global Public Health, School of Medicine and Health Sciences, Monash University, Sunway campus, Jalan Lagoon Selatan, Malaysia.
ROBERT POOL
Affiliation:
Centre for Social Science and Global Health, University of Amsterdam, The Netherlands.
*
Address for correspondence: Natalie Evans, Department of Public and Occupational Health, EMGO+ Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands E-mail: [email protected]
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Abstract

Malaysia has an ageing population and an increasing number of older people who live alone. This study explores the social support and care arrangements of older people living alone in rural Malaysia. The study took a qualitative approach: semi-structured interviews were conducted with a purposive sample of Malay (N = 20) and Chinese (N = 20) Malaysians aged over 65. Five cross-cutting themes were identified through a thematic analysis: degrees of aloneness; relationships and social support; barriers to social support; and future illness, care and death. All participants said they lived alone; living arrangements, however, were often complex. For Malays, most support came from nearby adult children and relatives, whereas Chinese participants, who less frequently had adult children living locally, emphasised support from friends and neighbours. Emigrant adult children's assistance was mostly informational and financial, instrumental assistance was either substituted for money, or provided solely during periods of ill-health. Physical decline, limited telephone use, inadequate transportation and fears of crime were barriers to social support. Participants avoided thinking or talking about future care needs. These findings have implications for Malaysian old age policy, which is currently focused on supporting families to care for older relatives. Child migration and a growing preference for a period of independent living in old age may require policies and resources directed at older people as individuals to support their own efforts to remain independent, active and age ‘in place’.

Keywords

inter-generational supportmigrationSouth-East Asiapopulation ageingsocial supportsocial capital
Type
Article
Information
Ageing & Society , Volume 38 , Issue 10 , October 2018 , pp. 2061 - 2081
Copyright
Copyright © Cambridge University Press 2017 

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References

Allotey, P., Reidpath, D. D., Devarajan, N., Rajagobal, K., Yasin, S., Arunachalam, D., Imelda, J. D., Soyiri, I., Davey, T., Jahan, N. and the Seaco Team. 2014. Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia. Global Health Action, 7, 1, 23176.Google Scholar
Ambigga, K. S., Ramli, A. S., Suthahar, A., Tauhid, N., Clearihan, L. and Browning, C. 2011. Bridging the gap in ageing: translating policies into practice in Malaysian primary care. Asia Pacific Family Medicine, 10, 2, doi:10.1186/1447-056X-10-2.Google Scholar
Antman, F. M. 2010. Adult child migration and the health of elderly parents left behind in Mexico. The American Economic Review, 100, 2, 205–8.Google Scholar
Beard, J. R., Officer, A., de Carvalho, I. A., Sadana, R., Pot, A. M., Michel, J. P., Lloyd-Sherlock, P., Epping-Jordan, J. E., Peeters, G., Mahanani, W. R., Thiyagarajan, J. A. and Chatterji, S. 2015. The world report on ageing and health: a policy framework for healthy ageing. The Lancet, 387, 10033, 2145–54.Google Scholar
Bell, M. and Muhidin, S. 2009. Cross-national Comparison of Internal Migration. Human Development Research Paper (HDRP) Series, Volume 30, United Nations Development Programme. Available online at https://mpra.ub.uni-muenchen.de/19213/ [Accessed May 2015].Google Scholar
Chan, A. 2005. Aging in Southeast and East Asia: issues and policy directions. Journal of Cross-cultural Gerontology, 20, 4, 269–84.Google Scholar
Chung, I., Wong, C., Oh, C. and Ho, S. Y. 2013. Implementing a national Advance Care Planning (ACP) programme in Singapore. BMJ Supportive & Palliative Care, 3, 2, 256–7.Google Scholar
Cohen, S., Gottlieb, B. and Underwood, L. 2000. Social relationships and health. In Cohen, S., Gottlieb, B. and Underwood, L. (eds), Measuring and Intervening in Social Support. Oxford University Press, New York, 3–25.Google Scholar
Croll, E. J. 2006. The intergenerational contract in the changing Asian family. Oxford Development Studies, 34, 4, 473–91.Google Scholar
Department of Social Welfare Malaysia 1995. National Policy for the Elderly (NPE). Ministry of National Unity and Social Development Malaysia, Kuala Lumpur.Google Scholar
Department of Social Welfare Malaysia 2011. National Policy for the Elderly (NPE). Ministry of National Unity and Social Development Malaysia, Kuala Lumpur.Google Scholar
Department of Statistics Malaysia 2010. Population Distribution and Basic Demographic Characteristics. Available online at www.statistics.gov.my [Accessed May 2015].Google Scholar
Doty, P. 2010. The evolving balance of formal and informal, institutional and non-institutional long-term care for older Americans: a thirty-year perspective. Public Policy & Aging Report, 20, 1, 3–9.Google Scholar
Fold, N. 2000. Oiling the palms: restructuring of settlement schemes in Malaysia and the new international trade regulations. World Development, 28, 3, 473–86.Google Scholar
Grimmer, K., Kay, D., Foot, J. and Pastakia, K. 2015. Consumer views about aging-in-place. Clinical Interventions in Aging, 10, 1803–11.Google Scholar
Htut, Y., Shahrul, K. and Hua Poi, P. J. 2007. The views of older Malaysians on advanced directive and advanced care planning: a qualitative study. Asia Pacific Journal of Public Health, 19, 3, 58–66.Google Scholar
Hu, Y. H. 1995. Elderly suicide risk in family contexts: a critique of the Asian family care model. Journal of Cross-cultural Gerontology, 10, 3, 199–217.Google Scholar
Jahan, N., Allotey, P., Arunachalam, D., Yasin, S., Soyiri, I., Davey, T. and Reidpath, D. D. 2014. The rural bite in population pyramids: what are the implications for responsiveness of health systems in middle income countries? BMC Public Health, 14, supplement 2, S8.Google Scholar
Kooshiar, H., Yahaya, N., Hamid, T. A., Samah, A. A. and Jou, V. S. 2012. Living arrangement and life satisfaction in older Malaysians: the mediating role of social support function. PloS One, 7, 8, e43125.Google Scholar
Lamb, S. 2014. Permanent personhood or meaningful decline? Toward a critical anthropology of successful aging. Journal of Aging Studies, 29, 41–52.Google Scholar
Lin, K., Yin, P. and Loubere, N. 2014. Social support and the ‘left behind’ elderly in rural China: a case study from Jiangxi province. Journal of Community Health, 39, 4, 674–81.Google Scholar
Lutz, W., Sanderson, W. and Scherbov, S. 2008. The coming acceleration of global population ageing. Nature, 451, 7179, 716–9.Google Scholar
Mehta, K. 1999. Intergenerational exchanges: qualitative evidence from Singapore. Asian Journal of Social Science, 27, 2, 111–22.Google Scholar
Ng, A. C. Y., Phillips, D. R. and Lee, W. K. 2002. Persistence and challenges to filial piety and informal support of older persons in a modern Chinese society: a case study in Tuen Mun, Hong Kong. Journal of Aging Studies, 16, 2, 135–53.Google Scholar
Samad, S. and Mansor, N. 2013. Population ageing and social protection in Malaysia. Malaysian Journal of Economic Studies, 50, 2, 139–57.Google Scholar
Scharlach, A., Graham, C. and Lehning, A. 2012. The ‘village’ model: a consumer-driven approach for aging in place. The Gerontologist, 52, 3, 418–27.Google Scholar
Sim, O. F. 2002. Ageing in Malaysia: a review of national policies and programmes. In Phillips, D. R. and Chan, Af (eds), Ageing and Long Term Care: National Policies in the Asia-Pacific. International Development Research Centre, Ottawa, 107–49.Google Scholar
Stones, D. and Gullifer, J. 2016. ‘At home it's just so much easier to be yourself’: older adults’ perceptions of ageing in place. Ageing & Society, 36, 3, 449–81.Google Scholar
Strauss, A. and Corbin, J. 2008. Open coding. In Strauss, A. and Corbin, J. (eds), Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Sage, Thousand Oaks, California, 61–74.Google Scholar
Takagi, E. and Silverstein, M. 2006. Intergenerational coresidence of the Japanese elderly: are cultural norms proactive or reactive? Research on Aging, 28, 4, 473–92.Google Scholar
Tey, N. P., Siraj, S. B., Kamaruzzaman, S. B. B., Chin, A. V., Tan, M. P., Sinnappan, G. and Müller, A. M. 2016. Aging in multi-ethnic Malaysia. The Gerontologist, 56, 4, 603–9.Google Scholar
Thillainathan, R. 2003. The employees provident fund of Malaysia: asset allocation, investment strategy and governance issues revisited. Paper prepared for presentation at the Conference on Public Pension Management, organized by the World Bank, 5–7 May, Washington DC.Google Scholar
United Nations 2015. World Population Ageing 2015 – Highlights. ST/ESA/SER.A/368, United Nations Department of Economic and Social Affairs, Population Division, New York. Available online at http://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Highlights.pdf [Accessed January 2016].Google Scholar
Woolcock, M. 2001. The place of social capital in understanding social and economic outcomes. Canadian Journal of Policy Research, 2, 1, 11–7.Google Scholar
Wu, Y. W. 1995. Three-generations Stem Family: The Myth and Trap. JuiLiu, Taiwan. (in Chinese)Google Scholar
Yang, N., Chen, C. C., Choi, J. and Zou, Y. 2000. Sources of work–family conflict: a Sino–US comparison of the effects of work and family demands. Academy of Management Journal, 43, 1, 113–23.Google Scholar