Growing old without children: aged care’s sleeper issue

The experiences of older people who are childless are being overlooked in aged care policy and planning despite their growing numbers, Cassie Curryer tells Linda Belardi.

Sociologist, Cassie Curryer’s research is shining a light on the largely ignored experience of growing old without children.

Specifically, Curryer is turning her attention to the circumstances of older women – their plans and expectations for ageing in place, the availability of support networks and their future care needs.

She talks to Community Care Review about why this issue demands our attention.

LB: Have governments come to grips yet with the growing phenomenon of childlessness and what this might mean for aged care policy?
CC: Aged care policy in Australia recognises that family, and particularly adult children, are an important source of informal care for older people. While this is often the case, a significant proportion of people will age without children to provide such support. Current estimates are that as many as one in four women in Australia will remain childless at the end of their reproductive life, whether by choice or circumstance. There are also significant numbers of men who do not have children. Among the post-Second World War baby boomer generation, around one in 10 women have never given birth, and many of these women will be single and living alone in later life. Existing research shows that older people who are childless are systematically ignored in aged care policy discussions, despite their increasing numbers. The government is currently seeking broad input on how to support the care of older people in their homes. This is a good opportunity to listen for the increasing numbers of childless older men and women who may have different needs and preferences for housing and services as they age.

What motivated you to research this area?
As a sociologist, I am keenly aware of social issues such as the gender disadvantage experienced by older women living in the community, and this is often compounded by lack of family support. I’m also very passionate about social policy, and of course, one of the biggest policy changes in Australia has been the move towards a more consumer-orientated and coproduced aged care system with a greater focus on ageing in the home. In my own observations of ageing friends and relatives and social policy research I’ve been engaged in, it became clear that childless women were a group that had received relatively little policy attention. This is also the case in the United Kingdom and United States. Of course, having children does not guarantee that support will be available, just as being childless does not mean that you will be especially vulnerable in older age. The experience of late-life childlessness will also vary between social, historical, economic and policy contexts. Despite the greater policy emphasis on consumer coproduction and innovation in aged care and housing services there has been little discussion with older people about their needs and preferences for care and support, and little understanding of how different circumstances – such as being childless – might influence consumer choices. Consequently, women without children might be missing out on support or have unique needs and preferences that have not been recognised.

What do we currently know about how childlessness impacts the experience of ageing and the need for and take up of services?
There is limited research that explores how late-life childlessness might influence the experience of ageing, and what research has been done tends to be outdated. It is known that older women who are childless are more likely to be residing in residential aged care than women who have children. This becomes especially marked for women aged 75 and older. Older childless women have also been shown to enter residential aged care at earlier ages, but more knowledge, for example about precipitating factors and decision-making processes, is needed to inform policy and services. Some studies report that older people who are childless tend to make greater use of formal home care services such as home maintenance and meal services, but the results vary between different policy and funding contexts. There is some suggestion that the lack of having someone to advocate on their behalf might mean that older people without children face significant difficulties accessing services when needed, particularly in times of acute health or other crisis, or when experiencing financial difficulty. It is also important to recognise that there is great diversity among people who do not have children, and this includes men and those who identify as LGBTI, as well as people whose children have predeceased them.

Is there evidence to suggest this group is less likely to be able to age in place at home?
Research shows that family plays a key role in supporting ageing in place. In the absence of family support, older people who do not have children draw on a wide range of coping skills, strategies, and social support networks in managing the demands of ageing. However, many of these networks will themselves be ageing or may not be able to provide intensive or ongoing support for any great length of time. Older adults who are childless also tend to use a variety of formal and informal services to support their independence, however there is insufficient information available about the types of services used, frequency of service use, or which services are most needed. As the foundation for the delivery of aged care services, having housing that is suitable and affordable for their needs will be an important part of supporting older people to age in place in their communities. An additional consideration is that older childless individuals’ needs and preferences for housing and for care may be different to those with children. Research out of the UK suggests that having someone to advocate for them on their behalf, having someone to call on in an emergency, social interaction, and having help with information seeking and accessing services are key concerns for people ageing without children. Older women who are childless are also more likely to be single and living alone, and this poses additional challenges given women’s gender disadvantage over the life course and the lack of affordable and suitable housing, particularly for women residing in rental accommodation.

What are you hoping this research will achieve?
This is one of very few qualitative studies exploring the social and housing circumstances of older women who are childless. The research focuses on women born during the post-Second World War baby boom. It seeks to challenge policy assumptions regarding family care, and to raise awareness of this diverse group of women whose needs and preferences for housing and support services have not been fully explored. Ideally, the findings from my research will be used to inform service and policy development.

What are some potential impacts of this growing cohort for service providers?
This year in the UK, the number of older people needing care will surpass the number of family members able to provide it. Similar projections are being seen in Australia, in line with population ageing and the increasing numbers of older people who are childless in later life. While this poses challenges for aged care services delivery, there are opportunities to be gained in greater consumer engagement and the development of housing and services uniquely tailored to the needs and preferences of older people who do not have children to provide support. People born during the post-Second World War baby boom are looking for new and creative opportunities for ageing in place, but they may not be aware of all the options available. As childless older adults are more likely to make greater use of formal and user-pay services, it is important that providers engage in discussions about the types of accommodation and services that are needed.

Cassie Curryer is a PhD candidate at the University of Newcastle and her research is expected to be completed next year. This article appears in the current edition of Community Care Review magazine.

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