According to Maslow's Hierarchy of Needs explanation of individual decision-making, human motivation is based on individual needs, which are physiological needs, security needs, social needs, respect needs, and self-realization needs from low to high [8]. Only when the lower level needs are met, will they begin to pursue the higher level needs; And after the needs of lower levels are fully met, it will no longer have an incentive effect on individual behavior. As a behavioral decision, the willingness of the elderly to provide for the aged in institutions reflects the willingness of the elderly in different situations and the different expectations of the elderly in different situations for the aged in institutions. This paper attempts to use Maslow's hierarchy of needs theory to explain the willingness of the elderly to provide for the aged under the influence of different factors.
Here, according to the common five-step demand hierarchy, the pursuit of basic physical needs of food, clothing, housing and transportation, life security, and disease prevention are regarded as the pursuit of the elderly at the level of life support. Senior social needs, respect needs, and self-realization needs are regarded as the pursuit of the elderly to ensure their quality of life. If the physical condition of the elderly is in urgent need of special care, but the traditional family pension method is difficult to meet this demand, they will face the pressure of life support, which is the pursuit of life support; On the contrary, the better the physical condition, the less the pressure of life support. The demand for life support will no longer stimulate the elderly's willingness to provide for the elderly but will be generated from the pursuit of ensuring the quality of life.
Maslow's Hierarchy of Needs theory analyses the actual root causes of decision making from the perspective of human needs and has strong explanatory power for the analysis of willingness. According to the above detailed analysis of the factors influencing the two main factors that generate the elderly's willingness to age, the results are: the pursuit of basic needs in the categories of food, clothing, shelter, livelihood security and disease prevention can be reflected by the variables health status, life care and emotional support [9,10]. The social needs, respect needs and self fulfilment needs of older people can be reflected by the variables social participation, cognitive ability, and social coping [11,14]. To facilitate the measurement of the extent to which variables influence the willingness of rural older people to accept institutional care, this paper will further refine and classify the variables.
In their study, Melanie (2011) and others suggest that the likelihood of older people receiving family life care is influenced by the number of adult children, marital status and care among friends, i.e. older people who have more children or are married with a spouse are able to receive more life care than those who have fewer children and no spouse [18]. Similarly, Bella J K (2014) mentioned that older people's emotional support is equally influenced by themselves, their families and the outside world, and that when older people's self-support for the fact of being institutionalized rises, the more courageous they are to be able to accept institutional services; when family members tend to support parents staying in elderly care institutions, the willingness of rural elderly people to receive nursing services from elderly care institutions will increase. These factors can be measured by variables such as 'the degree of trust one has in an institution' and 'the degree of support one's children have for one's parents to move into an institution'[20]. In addition, the higher level needs of older people are influenced by the overlapping resources that older people have in terms of material and spiritual conditions, and according to Won I (2008), these variables can be measured by economic income, the long-term occupation of older people and the level of education [9]. In other words, the economic level of the elderly will largely influence the changes in the level of their needs. When the material resources available to the elderly are sufficient to support them to stay in a nursing home and enjoy more professional services, they will gradually develop the need to stay in a nursing home in order to guarantee their quality of life. However, when the economic level of the elderly cannot support their choice of more comfortable elderly care methods, the willingness of rural elderly people to stay in elderly care institutions will be greatly suppressed. In addition, the respect and self fulfilment needs pursued by older people are influenced by their level of self-thought, which can be measured by their long-term occupation and education [21].
Based on extensive previous research and theoretical foundations, this paper will use variables such as physical condition, marital status, number of children, annual household income, educational attainment, occupation, trust in elderly care institutions, and support from adult children to measure the impact on rural elderly people's willingness to receive institutional care services. The influencing factors belonging to the individual elderly person are divided into individual characteristics, those belonging to the elderly person's family resources and abilities are divided into family characteristics, and those belonging to the elderly person's cognitive level and subjective influence are divided into subjective normative factors. In addition, this paper adds the variable of older people's knowledge of elderly care institutions to better understand the influence of older people's subjective normative factors on their willingness to age. The analytical framework of this paper is shown in Table 1.
Individual characteristics, family characteristics and subjective normative factors combine to influence the reality of demand for institutional care services for rural older people. Secondly, as institutional care is a form of consumption, the determining factor for consumption is the capacity to demand, which comes from the various resources that older people have. Among them, the ability or resources from outside the household can be reflected by the physical condition, education level, occupation, support from children, and the level of understanding and trust in the aged-care institution; the resources or ability within the household can be reflected by the number of children, annual household income and marital status. To this end, the following research hypotheses are proposed in this paper:
(I) Individual characteristics research hypothesis
Personal characteristics have an important impact on whether the elderly accept the services of pension institutions. The existing research on personal characteristics mainly includes several aspects: basic personal information (gender, age, physical condition, education level, etc.) and personal occupational factors. Previous studies have shown that age, marital status, physical quality, and education level have a significant impact on the elderly's choice of pension methods, which reflects that the elderly and the elderly with poor physical quality need more professional services from pension institutions. This article will focus on three factors: the health status, education level, and occupation of the elderly. First of all, health is the most basic factor to ensure the maintenance of personal life. According to Maslow's hierarchy of needs theory, having good health will lead to an increase in the pursuit of quality of life for the elderly. However, when the resources and abilities of the elderly are not enough to support them to choose nursing services in the nursing home, or when they can support the elderly to choose a more comfortable way of retirement, their willingness to accept nursing home services will decline.
Secondly, education level is the simplest way to measure the cognitive ability and ideological level of the elderly [10]. The education level of the elderly may affect their scientific understanding of the nursing home. Thirdly, according to the endowment capital theory, the occupation of the elderly plays an important role in the decision-making process of whether to choose an endowment institution. The wage level and occupational nature of work will affect the choice and traditional cognition of the elderly. For example, older people who work in businesses and state institutions in the nature of their occupation shows that the elderly can timely, fully, and correctly understand the necessity and rationality of national policies and the existence of pension institutions, and the possibility of choosing pension institutions will be higher.
Based on this, the following assumptions are put forward about the impact of individual characteristics on the elderly's willingness to provide for the elderly in institutions:
H1: The impact of individual characteristics on the willingness of rural elderly to accept the services of elderly care institutions:
H1a: The worse the physical condition of the elderly, the higher the possibility of choosing institutions to provide for the elderly;
H1b: The higher the education level of the elderly, the higher the possibility of choosing institutional pension services;
H1c: Older people are more likely to be exposed to new things in their work and are more willing to accept the nursing services of elderly care institutions.
(II) Family characteristics research hypothesis
Under the influence of family culture that attaches importance to kinship in China, the elderly's willingness to provide for the elderly in institutions will be greatly affected by family factors in addition to their basic personal conditions. Just as the Xie Lili, Wang Bin (2019) summed up three social participation models of the elderly in China through the comprehensive measurement of the economic participation, political participation, public participation, and family participation of the elderly: high participation model, low participation model, and family care model. The family care model is a unique model of the elderly in China, which has not yet appeared in western research [12]. It can be seen that the rural elderly with institutional pension motivation may also face obstacles from family characteristics.
In the existing studies, the family characteristics of the elderly mainly include family relationships, number of children, marital status, and annual family income. Among them, most scholars believe that the rural elderly with fewer children, more family income, and no spouse is more inclined to rely on the social pension. This article will focus on the family resources and demand capacity factors that affect the elderly's willingness to provide for the elderly in institutions, including family annual income, marital status, and the number of children.
Elderly care institutions often put forward requirements for the economic conditions of service users. Compared with the rural elderly with poor family finances, the elderly with more annual income or higher socio-economic status can more afford the institutional pension costs, so the possibility of choosing institutional pension services will be higher. Moreover, family care is an essential and important factor in the traditional way of providing for the aged at home. However, due to the reduction of rural employment opportunities, a large number of young and middle-aged people go out to work, resulting in the reduction of necessary resources for family care. Most of the care support and emotional comfort needed by the elderly in their later years come from friends, spouses, children, and even family networks [11]. When such needs are difficult to meet, the demand for institutional pensions will increase. For example, the elderly without a spouse are more likely to choose an elderly care institution, and the more children there are, the more likely they are to be cared for by their families, thus reducing the need for institutional care. Based on this, this paper puts forward the following assumptions:
H2: The impact of family characteristics on the willingness of elderly people in rural areas to receive services from elderly care institutions:
H2a: The lower the family's annual income, the lower the possibility of the elderly choosing institutional pension services;
H2b: The elderly with spouses are unlikely to receive nursing services from elderly care institutions;
H2c: The more children, the lower the willingness of the elderly to accept nursing services in the nursing home.
(III) Subjective normative factor research hypothesis
The reason for the low proportion of institutional pensions is that on the one hand, the development of pension institutions does not meet the expectations of residents, and on the other hand, the subjective will of the rural elderly to choose the services of the elderly care institutions fluctuates under the influence of the external environment. Previous studies have shown that the subjective normative factors that affect the elderly's acceptance of institutional elderly care services usually include the impact of external public opinion, the degree of children's support for their parents to stay in the nursing home, and the impact of the elderly's perception of the nursing home [13]. In order to clearly understand the impact of cognitive ability and external resources of the elderly on whether the elderly accept pension institutions, this paper selects the support of children, the understanding of elderly care institutions, and the trust of elderly care institutions as the main research objects.
China's pension culture and tradition are unique. In the local context, the topic of pension cannot be separated from the "family" [14]. The "responsibility ethics" in China's elderly care culture requires children to "feedback" to their parents, but parents' understanding of their children's life pressure can have a positive impact on their breaking away from the shackles of traditional concepts, which is also part of China's traditional family concept, that is, parents love for their children is far higher than all the shackles of the outside world [15]. Therefore, when the children's living burden is increasing and they are supportive of their parents entering the nursing home, the parents will choose to listen to their children's opinions because of their understanding of the pressure on their children's lives, so the possibility of choosing institutional elderly care services increases. Secondly, the more elderly people know about the location, price, service content, and other aspects of elderly care institutions, the more they can determine whether their life in their later years can be fully guaranteed and respected, so as to make the best choice according to their actual situation, that is, to accept the way of elderly care institutions [16]. At the same time, when the elderly have a supportive and trusting attitude towards the service content, service attitude, and management system of the elderly care institutions, they will also tend to choose institutions for elderly care. Based on this, this paper proposes the following research assumptions:
H3: The impact of subjective normative factors on the willingness of rural elderly people to accept the services of elderly care institutions༚
H3a: When children hold a supportive attitude towards their parents' living in an elderly care institution, the higher the possibility of elderly people choosing institutional elderly care services;
H3b: The higher the elderly's understanding of the elderly care institutions, the higher the possibility of the elderly choosing institutions for elderly care;
H3c: The stronger the trust of the elderly in the elderly care institutions, the higher the possibility of the elderly choosing the institutions for elderly care.