To address the research questions, firstly, the qualitative approach allowed for obtaining data that yielded thick descriptions of adaptation experienced by older migrants. During the interview process, in addition to difficulties appearing in sociocultural and psychological adaptation process, older migrants who participated in this study reported what social support they obtained to deal with difficulties. Then we modified and applied quantitative instruments to determine whether potential associations existed between different types of perceived support and two-dimensional adaptation. This exploratory sequential study where qualitative phase inquiry precedes quantitative survey placed an equal emphasis on answering the question of what challenges appear in different dimensions of adaptation and how various types of support promote adaptation (Rubin & Babbie, 2017; Creswell & Plano, 2017). The equal integration of quantitative and qualitative findings could yield more meaningful insights than the findings of a single method and examine the mechanisms of social support and adaptation from qualitative phase (Creswell & Plano, 2017).
3.2 Results of Interviews
From interviews, sociocultural adaptation among older migrants was divided into two categories: environmental adaptation and relationship adaptation. Environmental adaptation included community integration and social welfare issues. Relationship adaptation included relationship maintenance of left-behind family and friends, role changes with co-living children and social connection to host cities. Psychological adaptation is defined as affective reactions to migration. Many older migrants felt struggling and loneliness due to caregiving intensity and separation with family and friends in hometown.
Family Support and Formal Social Support Promoting Community Integration
The most obvious challenge was the process of adaptation to the new living environment. Many older migrants reported it took them more than a half year to get familiar to the new community, especially for those from rural areas. For example, Ms. Ai noted, “When I need to go out, they [my children] have to take me there; otherwise, I will get lost”. Moreover, because of the frequent relocation of their children, older migrants reported that they were unable to maintain continuous relationships with their neighbours or to continue participating in social activities because they had to move with their children.
Regarding handling environmental challenges, support from adult children was the first resource that older migrants received. Because they were not familiar with the host city, they might depend on their children for instrumental support, such as shopping and seeking medical assistance. Specifically, when they encountered difficulties, they would first turn to their adult children for support. More than half older migrants mentioned they shared their feelings with their co-living children, which brought emotional comfort to them.
My adult children supported me to go shopping, going to the hospital, bank…They are willing to provide support. When I missed home, I talked with my daughter-in-law. Yes, they are helpful. (Mrs. Ai)
In addition, the community organised activities to promote the integration of older adults. Various leisure activities, such as dancing and singing groups, were organised to cater to older participants with different interests. Most older migrants regarded these activities as meaningful. For example, Mr. Li said, “I would like to participate in dancing and singing activities organized by our community because I can make friends who share same interests with me”. To help older adults keep abreast of the modern world, some communities provided mobile phone use workshops, which demonstrated searching for news online, online shopping, and taking and editing photos. In these social groups, older migrants were likely to develop social networks while they became familiar with the new technologies.
Enhancing Medical Security with Informal and Formal Social Support
The household registration (hukou) system in China is a registration system that links individuals to a specific geographic location, either rural or urban (Ruan et al., 2019). In terms of the medical system, hukou status plays an important role in determining individuals' access to medical care. Under the current system, individuals are only eligible for medical benefits in the city or region where their hukou is registered. This system has created significant challenges for migrants who may not have access to medical care in their new location. Older migrants reported they hesitated to go to the hospital when they were sick because the percentage of reimbursement was low. They all mentioned difficulties to obtain reimbursement because they had to travel back to their hometowns due to the household registration system (Dong, 2009; Ruan et al., 2019). As such, family or friends in hometown supported them with reimbursement procedures. In addition, out-of-pocket payments were common in getting medical treatment and saving money for future use was also important. Most older migrants reported that the community organized yearly physical check-ups for older adults above 65 years old and this assistance supported them to detect diseases as early as possible.
My medical insurance is based in my hometown, so we can only obtain reimbursement if we are hospitalised; otherwise, we have to pay for registration fees and medicines ourselves. In addition, it takes a long time to obtain reimbursement, so we are afraid of becoming ill. (Mr. Tang)
Maintaining Acquaintance-based Networks to Obtain Psychological Comfort
Most of the older migrants reported that they still had older parents or siblings in their hometowns. However, because of their caregiving role and limited mobility during the pandemic, it was impossible for them to regularly visit their hometowns. For example, Mr. Cui said, “As my father and parents-in-law are still in my hometown, I pay a visit to them each month. Usually, I stay in hometown for a month and return to the host city because my wife needs my support in grandparenting”.
Although older migrants had left their hometowns, maintaining relationships with relatives and old friends could promoted their well-being and strengthened their resilience. Mr. Kuang said, “I am able to get in touch with my good friends and classmates in my hometown right away via my phone. We talk with each other as long as we have time, which reduces my feelings of homesickness.” However, several older migrants reported that contact by mobile phone was not as satisfactory as meeting in person. Both Mr. Zheng and Mr. Xun expressed, “Although communication online is convenient, it is still a pity that we could not have dinner or talk face-to-face”. In addition, for some participants, digital literacy and mobile phone expenses hindered them from being in touch with their hometowns.
Older migrants also needed to adapt to potentially new changes in their relationships with their spouses. In this study, several older migrants had moved to the host city without their spouses because they had not retired. Under these circumstances, in addition to the adaptation to a new environment, older migrants had to maintain a remote relationship with their husband or wife using mobile devices and social media.
Adjusting to Caregiving Role with Family and Peer Support
Living with children, older migrants may experience different life styles and family role changes. Based on traditional Chinese values of filial piety, parents are responsible for raising their children, and it is the responsibility of adult children to take care of their older parents (Lai, 2010). However, after migration, the roles of older migrants changed. They were caring for their adult children or grandchildren, so they felt their self-control and autonomy had decreased. Although the lifestyles of many older migrants differ from those of their children, older migrants might choose to keep harmonious communication with them or even make compromises. Mr. Zheng said, “We, both sides, make compromises, of course. There are conflicts existing in our family. Most of the time I make compromises and let the conflicts go”.
To alleviate their psychological burden, older migrants shared feelings with friends they made in host cities. Most of the older migrants had developed social networks with other older adults through their grandchildren’s kindergarten, local communities, and activities organised by the neighbourhood. Many of whom were also grandparents. This collective identity brought them together. For example, Mr. Qian said, “I get to know some people when I take a walk with my grandchildren. When my grandson went to kindergarten, I became familiar with some of the grandparents of his classmates. We chatted with each other when we have problems”. Older migrants tried to seek psychological comfort from their friends both in host cities or hometown to help them accept the current situations. They encouraged each other that although migration was a passive choice because the grandchildren of these older migrants needed their care, they tried to emphasise the positive aspects of their caregiving role. They also shared pictures and interesting family stories with old friends and family in hometown to keep up to date with each other’s lives.
I shared pictures of my grandson and my life here through WeChat with my friends in hometown and other host cities and they sent theirs. We shared sorrow and happiness. Although we could not meet in person, we could still encourage each other. (Mrs. Liang)
Improving Psychological Resilience with Peer Support in Host Cities
Some participants experienced feelings of homesickness and loneliness because they found it difficult to adjust to life in the new environment. Mr. Qian said, “I feel I have adapted to the new environment, but I still think it is more comfortable living in my hometown. I miss my hometown. This kind of homesickness comes from missing familiar people there”.
Moreover, instead of a traditional hierarchical family relationship, in which parents have the most authority and power, as grandparents, the older migrants’ priority was caring for their children’s family. However, faced with the demands of caregiving, some older migrants felt upset or overwhelmed. For example, Ms. Guo felt that she had been “sentenced to the caregiving role as the second grandchild was born”.
With negative emotions, older migrants were likely to seek emotional support to improve their resilience and encourage themselves to adapt to the current situation. Some older migrants communicated with their co-living children and some shared happiness and sorrow with other grandparents in the neighborhood. In developing friendships, it seemed that older migrants had inadvertently been mindful of their identities as migrants, not locals. Mr. Zheng offered, “I did not have any friends in this community because people here are locals and have a higher educational background. But I am from the countryside, so I seldom talked with them”. Moreover, when they knew others who had migrated from the same hometown, it was easier to develop friendships. Subsequently, these relationships could become their preferred social contacts.
In summary, the qualitative results demonstrated that challenges in sociocultural and psychological adaptation process were inevitable for older migrants when they moved to their host cities. With support from host cities and hometowns, many of them tried to focus on the importance of family and adaptation to the caregiving role.
3.5 Results of the Survey
Based on the interview findings, the association of different types of social support with sociocultural and psychological adaptation was examined. Then, whether each type of social support was associated with these two aspects of adaptation was determined via linear regression analysis while controlling for demographic variables, including age, gender, education, pension level, household registration type (Hukou), marital status, household size and self-rated health score.
Table 1 presents the correlations between the two aspects of adaptation and different dimensions of social support. Both informal support (B = .168, p < .01) and formal support (B = .276, p < .01) in the host city were significantly associated with sociocultural adaptation. Relationships with informal support from hometowns and technical support in connecting with hometowns were insignificant. However, all four dimensions of support were positively associated with psychological adaptation.
Table 1
Bivariate Analysis Between Adaptation and Perceived Social Support
| Sociocultural adaptation | Psychological adaptation |
Informal support in host city | 0.168** | 0.439** |
Informal support from hometown | 0.071 | 0.283** |
Formal support from community | 0.276** | 0.127* |
Mobile phone use to connect hometown | -0.095 | 0.282** |
Note. N = 376; +p < .1; *p < .05; **p < .01; *** p < .001. |
[Insert Table 1here]
As shown in Table 2, when different types of support were entered into the model, informal support from relatives and friends in the host city and community services were positively related to sociocultural adaptation (B = .276, SE = .091, p < .01; B = .23, SE = .049, p < .001), which implied that the sociocultural adaptation of older migrants who received high amounts of these two types of support would improve. Specifically, support from relatives and friends imposes more effect. Other types of perceived support (i.e., informal support from their hometown and technical support to connect with their hometown) were not statistically associated with sociocultural adaptation.
Table 2
Regression Models Predicting Socioecological Adaptation (N = 376)
Variables | Model 1 | Model 2 |
Informal support in host city | | 0.276 (0.091) ** |
Formal community support | | 0.223 (0.049) *** |
Informal support from hometown | | 0.053 (0.072) |
Mobile use to connect hometown | | -0.117 (0.037) |
Age | -0.003 (0.007) | -0.005 (0.007) |
Gender (Male = 1) | -0.104 (0.059) + | -0.031 (0.058) |
Education | -0.019 (0.063) | 0.015 (0.064) |
Pension | 0.350 (0.091) *** | 0.296 (0.088) ** |
Household registration (Hukou) (Urban household = 1) | -0.140 (0.089) | -0.133 (0.087) |
Marital Status (Partnered = 1) | 0.136 (0.095) | 0.064 (0.092) |
Number of households | 0.005 (0.043) | 0.016 (0.042) |
Self-rated health | 0.164 (0.050) ** | 0.162 (0.048) ** |
_cons | 3.078 (0.561) *** | 1.508 (0.674) * |
R2 | 0.104 | 0.198 |
Note. N = 376. Unstandardized coefficients were reported; +p < .1; *p < .05; **p < .01; *** p < .001. |
[Insert Table 2here]
As shown in Table 3, informal support from family and friends in the host city was the most significantly associated with psychological adaptation (B = .470, SE = .060, p < .001). Informal support from family and friends in the hometown was marginally associated with psychological adaptation (B = .084, SE = .048, p = .079).
Table 3
Regression Models Predicting Psychological Adaptation
Variables | Model3 | Model4 |
Informal support in host city | | 0.470 (0.060) *** |
Formal community support | | 0.030 (0.032) |
Informal support from hometown | | 0.084 (0.048) + |
Mobile use to connect hometown | | 0.009 (0.024) |
Age | -0.003 (0.005) | 0.003 (0.005) |
Gender (Male = 1) | 0.001 (0.042) | 0.059 (0.038) |
Education | 0.117 (0.045) ** | 0.083 (0.042) + |
Pension | 0.012 (0.064) | -0.020 (058) |
Household registration (Hukou) (Urban household = 1) | -0.142 (0.063) * | -0.066 (0.057) |
Marital Status (Partnered = 1) | -0.041 (0.067) | -0.093 (0.060) |
Number of households | 0.004 (0.031) | -0.023 (0.028) |
Self-rated health | 0.076 (0.035) * | 0.091 (0.031) *** |
_cons | 3.892 (0.395) *** | 1.228 (0.445) ** |
R2 | 0.043 | 0.245 |
Note. N = 376. Unstandardized coefficients were reported; +p < .1; *p < .05; **p < .01; *** p < .001. |
[Insert Table 3here]
The quantitative results indicated that accessible support from family and friends in the host city could most significantly facilitate both sociocultural and psychological adaptation among older migrants who participated in this study. Community service support only marginally improved older migrants’ sociocultural adaptation. Regarding remote support from their hometowns, connections with family and friends in older migrants’ hometowns were associated only with their psychological adaptation.