Establishing substitute families: Care arrangements for childless older people in urban China

While the issues of childlessness and social support in old age have received considerable attention in more developed countries, the phenomenon of aging without children in China has been relatively underexplored. The existing, albeit limited, literature highlights the vulnerability of the childless elderly in China and the inadequacy of social care services, which is predominantly directed toward most impoverished groups. This study examines the care arrangements and social support mechanisms for childless older people in urban China, emphasizing the role of community-level officers in this context. Drawing on in-depth interviews conducted in 2019 with 27 childless elderly individuals and 10 community-level officers in Shanghai, the study reveals the formation of community-based substitute families. These substitute families, comprising neighbors, extended family members, and friends, provide daily assistance, emotional support, and sometimes intensive care. The establishment of these substitute families hinges on the childless individuals’ ability to navigate public and social resources, as well as the institutionalized mobilization and informal work strategies of community-level officers. We argue that the care arrangements for childless older people are significantly shaped by the state's aging-in-place elder care policy. However, the effectiveness of this policy is mediated by the informal work strategies of community-level officers and the proactive care planning by the childless elderly themselves. Our findings offer important insights for improving the current family-based elder care policies and enrich our understanding of aging without children in urban China.