Terry Y. S. Lum

Measuring Filial Piety in the 21st Century Development, Factor Structure, and Reliability of the 10-Item Contemporary Filial Piety Scale

The experience and practice of filial piety have evolved in modern Chinese societies, and existing measures fail to capture these important changes. Based on a conceptual analysis on current literature, 42 items were initially compiled to form a Contemporary Filial Piety Scale (CFPS), and 1,080 individuals from a representative sample in Hong Kong were surveyed. Principal component analysis generated a 16-item three-factor model: Pragmatic Obligations (Factor 1; 10 items), Compassionate Reverence (Factor 2; 4 items), and Family Continuity (Factor 3; 2 items). Confirmatory factor analysis revealed strong factor loadings for Factors 1 and 2, while removing Factor 3 and conceptually duplicated items increased total variance explained from 58.02% to 60.09% and internal consistency from .84 to .88. A final 10-item two-factor structure model was adopted with a goodness of fit of 0.95. The CFPS-10 is a data-driven, simple, and efficient instrument with strong psychometric properties for assessing contemporary filial piety.

Neighborhood Support and Aging-in-Place Preference Among Low-Income Elderly Chinese City-Dwellers

OBJECTIVES Preferences for aging-in-place are unclear among low-income elderly Chinese city-dwellers, who are more likely to be geographically bound, to have little care support, but possess strong filial values and family cohesiveness. This study investigated the preferences for aging-in-place and its contributing neighborhood factors among low-income Chinese elderly in a metropolitan city. METHOD We conducted interviews with 400 older people residing in public housing estates in Hong Kong. RESULTS The majority of low-income elderly persons (80.4%) prefer to age in place even if their health and functioning has deteriorated beyond independent living. Logistic regression showed that (a) having very low income (<HK

The Effect of Depressive Symptoms and Antidepressant Use on Subsequent Physical Decline and Number of Hospitalizations in Nursing Home Residents: A 9-Year Longitudinal Study.

2,000/month) and not receiving means-tested welfare predicted lower preference for this option [odd ratios (OR) = 0.27]; and (b) having medical facilities within reach (OR =9.02); and (c) an elderly center in the area (OR = 2.98) were associated with a preference for aging in place, after controlling for demographic, and functioning characteristics. DISCUSSION Low-income elderly Chinese city-dwellers prefer to age in place, given appropriate neighborhood support. These findings can be interpreted in light of Lawtons ecological theory of aging and suggest a service model similar to the Naturally Occurring Retirement Community with Supportive Service Programs.

The impacts of community social capital on the life satisfaction of older adults in Hong Kong: the moderator role of intergenerational family capital.

OBJECTIVE To investigate whether depressive symptoms and antidepressant use at baseline predict the subsequent decline in physical functioning and number of hospitalizations in nursing home residents. DESIGN Observational study based on Minimum Data Set (MDS) 2.0. SETTING Six nursing homes in Hong Kong. PARTICIPANTS All nursing home residents (n = 1076) assessed with the MDS 2.0 in 2005 followed until 2013. MEASUREMENTS Outcome variables included annual performance in activities of daily living (ADLs) and number of hospitalizations within 90 days before each assessment. The presence of depressive symptoms at baseline was measured by the Resident Assessment Protocol triggered from the MDS 2.0 assessment. Records of antidepressant use and other control variables were exacted directly from the MDS 2.0 assessment. RESULTS The presence of baseline depressive symptoms did not have significant association with baseline ADLs and number of hospitalizations according to the multilevel mixed-effect model. However, it was associated with a faster deterioration of physical functioning (coefficient 0.03; 95% confidence interval [CI] 0.00-0.07) and an increase in the number of hospitalizations (coefficient 0.05; 95% CI 0.03-0.07). No significant difference between elders using antidepressants and elders who were free from depressive symptoms was observed. If depressive symptoms were presented but antidepressants were not used, a much sharper decline was evident (coefficient 0.06; 95% CI 0.02-0.09). CONCLUSIONS This study provided evidence that the presence of depressive symptoms is associated with more utilization of health care services. However, the use of antidepressants may play a significant role in altering the trajectory. The presence of depressive symptoms is a worrisome but treatable condition. Effective intervention/treatment should be called on.

Health Expectancies in Adults Aged 50 Years or Older in China

Objective: This study examined the moderator role of intergenerational family capital on the relationship between community social capital and life satisfaction of older Chinese adults. Method: The data were derived from a quota sampling of 372 older adults aged 60 and above, who were interviewed at four districts in Hong Kong in 2011. Multiple group analysis was employed to examine the proposed model. Results: For the low family capital group, community social capital was found to be a significant predictor of life satisfaction, even when the well-known covariates were controlled. However, the association between community social capital and life satisfaction was statistically non-significant among the high family capital group. Discussion: The findings highlighted the interplay between community social capital and intergenerational family capital, which supported community social capital replacement theory in understanding the mechanism linking social capital to life satisfaction in older age in a Chinese context. Community social capital can play a compensatory role in maintaining the mental health of older people. It is particularly important for older adults who lack family support and/or suffer from social isolation and loneliness in local communities.

Development of Six Arts, a Culturally Appropriate Multimodal Nonpharmacological Intervention in Dementia

Objective: The purpose of this study is to understand the functional health of older adults in China and to assess the potential for advancing healthy and active aging. Method: Data of 13,739 older adults aged 50 years and older from the China Health and Retirement Longitudinal Study in 2011 were analyzed. Life expectancy in good perceived health, chronic-disease-free life expectancy, active life expectancy, and severe impairment-free life expectancy were calculated using Sullivan’s method. Results: At age 50 years, older adults had a life expectancy in good perceived health of 7.0 and 6.7 years in men and women, respectively. They would remain chronic-disease-free for 8.4 and 8.6 years, without activity limitation for 23.6 and 26.0 years, and severe impairment-free for 21.4 and 24.2 years. Discussion: The world’s largest aging population was spending a substantial proportion of remaining life years in suboptimal health and well-being, while remaining largely independent in basic self-care without severe impairments.

Cultural adaptation of cognitive stimulation therapy (CST) for Chinese people with dementia: multicentre pilot study

PURPOSE There is accumulating evidence for the efficacy of nonpharmacological multimodal stimulation interventions in maintaining cognition and improving quality of life in people with mild-to-moderate dementia. However, the complex nature of these interventions limits their application in practice and research. We report here the design and development of a culturally appropriate framework, the Six Arts, to guide delivery of multimodal interventions in a Chinese community. DESIGN AND DEVELOPMENT The Six Arts are a core set of Confucian philosophy comprising 6 disciplines of rites, music, archery, charioteering, literacy, and numeracy. They correspond to major mind-body functional domains of social functioning; music and rhythm; visuospatial and fine motor skills; kinesthetic and gross motor skills; language and verbal skills; and executive function. Using Six Arts as a framework, we mapped theoretical principles and evidence-based nonpharmacological interventions of cognitive stimulation, physical exercise, and social activities against the 6 functional domains. From 2011, we field-tested the use of Six Arts in structuring intervention programs in 263 people in a dementia day center in Hong Kong. RESULTS The Six Arts was operationalized through the development of an intervention activity database, a scoring system for intensity level, and a service delivery model for application in dementia day centers. IMPLICATIONS Six Arts can be used as framework for structuring nonpharmacological group intervention programs in dementia day center in a metropolitan Chinese city. Its cultural appropriateness may facilitate communication and shared decision making with families with dementia in communities influenced by Confucian philosophy.

Spontaneously Reported Symptoms by Informants Are Associated with Clinical Severity in Dementia Help‐Seekers

Ageing of the Chinese population will drive a continued surge in dementia prevalence. Empirically tested non‐pharmacological interventions developed in western cultures may be implemented in Chinese. Cognitive Stimulation Therapy (CST) that originated in the UK has proven benefits on cognition and quality of life in people with dementia. We investigated the feasibility and cultural appropriateness of CST in Hong Kong Chinese (CST‐HK).

Protecting the rights of Chinese older persons in need of residential care: The social justice and health equity dilemma in the People's Republic of China

To investigate the predictive value of symptoms of dementia that the person or an informant noticed spontaneously in determining the clinical severity of dementia.

A new short measure of filial piety

Introduction, Helen Meenan, Nicola Rees, Israel Doron 1. Human Rights and Residential Care For Older Adult sin Sub-Saharan Africa: Case Study of Kenya, Isabella Aboderin, Cecilia Mbaka, Carolyne Egesa, and Hilda Akinyi Owii 2. Whats New in the Residential Care of the Elderly in the Arab and Islamic World? The Case Of Egypt, Mohamed A. Arafa 3. Human Rights and Residential Care For Older Persons - An Australian Perspective, Sue Field 4. Protecting the Rights of Chinese Older Persons in Need of Residential Care: The Social Justice and Health Equity Dilemma in the Peoples Republic of China, Michelle H. Y. SHUM, JD, Andy H. Y. HO, PhD, Hao LUO, PhD, Jun Fang WANG, MSW, Ying WANG, MA, and Terry Y. S. LUM, PhD 5. The residential care of older people in England and the special relevance of Dignity and Human Rights, Helen Meenan 6. In Search of Rights in a Paternalistic Environment: The Israeli Experience of Regulating Residential Care for Older Persons, Israel Doron 7. Human Rights and Residential Care for Older People in Japan, Takashi Amano, Naoki Ikegami, and Tomoaki Ishibashi 8. Residential Care in the United States: A Persistent Struggle for Quality, Dignity & Independence, Richard J. Mollot, JD 9. Dignity as a Theoretical and Legal Construct in The Context of Care For Older Persons and the Developing Human Rights Agenda for Older Persons, Dr Haris Kountouros and Dr Nicola Rees Conclusion, Israel Doron, Nicola Rees, and Helen Meenan