The Role of Contextual Factors in Shaping Urban Older Adults’ Intention of Institutional Care in China: A Mixed-Methods Study

Background: This mixed-methods study explores older people’s intention of institutional care and its contributing contextual factors, and the meaning given to their intention by older adults in the transitioning Chinese society. Methods: Guided by the extended Anderson model and frameworks of the ecological theory of aging, survey data collected from 1937 Chinese older adults were used. Transcripts from six focus group interviews were analyzed to incorporate the voices of the participants. Results: Community environment and services, health services, financial services, and regional service organizations were related to the institutional care intention of older people. The qualitative analysis showed that the reported conflicting feelings about institutional care was driven by the lack of supporting resources and age-friendly environment. The findings of this study suggested that the reported intention of Chinese older adults for institutional care may not be an ideal choice but a compromise or, in some cases, a forced choice. Conclusions: Rather than treating the stated institutional intention as a simple expression of older Chinese people’s likes or desires, the intention of institutional care should be understood within a framework that fully considers the influence of psycho-social factors and contextual organizations.