Who Can I Rely On? A Qualitative Narrative Study of Care Planning Among Childless Older Adults in Hong Kong

Background: Receiving care from family members, particularlyadult children, is traditionally the most common care expectation among olderadults in Chinese society. However, amid declining fertility and risingnon-marriage, little is known about how older adults without children plan fortheir future care needs. Methods: This qualitative study adopted a narrativeinquiry with 33 childless older adults aged over 50 in Hong Kong. Participantstook part in in-depth, semi-structured interviews that explored the perceptionsof ageing without children, emotional responses, and anticipated careplannings. Interviews were audio-recorded, transcribed verbatim, and analyzedthematically through iterative coding, constant comparison, and peer debriefingto enhance credibility and reflexivity. Results: Emotionally, participantsreported pervasive anxiety about an uncertain future, rooted in the absence ofa dependable support network and fears of becoming functionally dependent. Manyperceived a weakening of kin-based obligations and filial piety norms.Practically, they actively expanded non-kin networks, sought connections withchildless peers for emotional support and information, and engaged in earlyplanning for care. Several respondents regarded institutional care, includingoptions outside Hong Kong, as a realistic, though ambivalent, strategy whenintensive assistance becomes necessary. Discussion: The findings reveal howchildless older adults negotiate care expectations. Their strategies highlightthe growing importance of non-kin ties, peer support, and cross-borderinstitutional care in later-life planning. Policies that strengthencommunity-based networks, improve access to affordable residential care, andexplicitly recognize the needs of childless older adults are crucial forpromoting dignified and secure ageing in rapidly changing Chinese societies.