Who is providing care for the elderly in Asia? Comparing five countries at different stages of demographic transition

Marie Ishida, Nossal Institute for Global Health
Ajay Mahal, Nossal Institute for Global Health, School of Population and Global Health, The University of Melbourne
Sumit Kane, Nossal Institute for Global Health, School of Population and Global Health, The University of Melbourne
Victoria Fan, Center for Global Development
Teralynn Ludwick, Center for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne

This paper investigates the characteristics of primary caregivers of adults aged 65 years and over in five Asian countries - Japan, Korea, China, Indonesia, and India - using data from large-scale household surveys. Among respondents, 13% to 37% reported receiving support with activities of daily living. The average number of hours care received per week ranged from 17 hours in Indonesia to 28 hours in Korea. The share of individuals primarily receiving care from external resources such as domestic workers and professionals was over 10% in Japan, Korea (excluding institutional care) and China, but as low as 4.1% in Indonesia and 1.0% in India. We also found people with higher economic status were more likely to use external care across the five countries. Among family caregivers, spouses were the main source of care, but care responsibilities transferred to young generations, mostly women, as recipients aged. This generational transition occurred more rapidly in India and Indonesia, where younger cohorts were increasingly assigned to the caregiving roles, including grandchildren. As the demographic transition deepens, and family sizes and structures change, newly ageing societies such as India and Indonesia will need to find strategies to substitute for younger family members in caregiving roles.

Keywords: Health and Morbidity, Older Adults and Intergenerational Relations, Mortality and Longevity, Human Capital, Education, and Work

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