How is family support linked to older adults’ well-being in South Asia?

Details

Traditionally, family members care for older relatives in South Asian societies, with strong reciprocal filial obligations across generations. Changes in family structure and living arrangements, along with out-migration, have changed reciprocal family support in ways that influence older adults’ health and well-being.

This scoping review aimed to map evidence and prevailing motivations for financial, practical and emotional family support affecting older adults’ health and well-being, and to identify research gaps on those motivations amid demographic and societal change in South Asia. The researchers followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guidelines. They searched PubMed, Embase, Scopus and ProQuest, and used Google Scholar to identify grey literature. Screening titles, abstracts and full texts yielded 22 studies for analysis.

The studies considered indicators of older adults’ well-being including stress and/or depression, loneliness or isolation, loss of support or neglect, and satisfaction. Adult children recognised duties and responsibilities to care for older parents, while older parents provided cultural upbringing and care to grandchildren. Reciprocal care, cultural expectations and intergenerational transfers motivated adult children to be their older parents’ primary caregivers. Financial, practical and emotional support across generations was associated with higher life satisfaction and lower depression, and with reported better health and well-being among older adults.

The review concluded that intergenerational support remains significant to older adults’ well-being in South Asia, but also described complex intergenerational ambivalence: caregiving responsibilities bring both emotional stress and a sense of obligation. It also reported that adult children’s out-migration and resulting physical absence increase older adults’ psychological distress and loneliness. The authors emphasised the need for policies addressing both emotional and financial aspects of elder care. They suggested adopting policies from the Madrid International Plan of Action on Ageing (MIPAA) to create friendly, supportive environments and emphasise older adults’ health and well-being in developing countries. MIPAA highlights policies promoting intergenerational solidarity, active ageing and social protection for older people.