Abstract
This study explores elderly volunteers’ identity during their experiences volunteering in the community in Shanghai. Purposive and snowball sampling strategies were used to recruit elderly volunteers to participate in semi-structured, in-depth interviews (N = 40). Participants developed new identities during volunteering. Through volunteering, they also continued to sustain their professional identities and Chinese Communist Party identities. Volunteering had both positive and negative implications for participants’ identities. Our findings suggest that volunteering strengthened participants’ role identity and social identity to better adapt to life after retirement. Volunteering also helped participants achieve identity continuity. This study offers nuanced sociocultural context to current elderly volunteering research and informs tailored policy and practice development in urban China.
Since the 1980s, the concept of productive aging has been a counterbalance to the stereotype of older adults’ frailty, and one of the most important vehicles for productive aging is volunteering (Morrow-Howell, 2010; O’Reilly & Caro, 1995). Volunteering refers to an activity that is voluntary, limited-reward, organized (e.g., nonprofit and governmental organizations), and beneficial to others (Cnaan et al., 1996). Older adults are motivated to volunteer to stay socially active, achieve generativity (Morrow-Howell, 2010), and maintain a sense of usefulness (Morrow-Howell et al., 2015). Elderly volunteers, possessing rich human capital, have become valuable assets to society (Gonzales et al., 2015).
Given the increasing life expectancy and overall aging trend in China, the Chinese government has also recognized the value of elderly volunteers and advocated productive engagement for older adults (lao you suo wei), encouraging their continuing contribution to community and society. Volunteering in the community—such as doing voluntary work and participating in governmental or nonprofit community-based organizations—has rapidly become one of the most popular patterns of productive aging in China (Liu & Lou, 2016). Elderly volunteers in urban China prefer to work for formal organizations in the community (Du et al., 2015). Recent studies have reported that volunteering is significantly associated with positive health outcomes for Chinese older adults, such as lower levels of depression (Y. Li et al., 2013; Liu & Lou, 2017), higher levels of well-being and life satisfaction (Dai, 2013), and better self-rated health status (Mjelde-Mossey et al., 2009). Chinese older adults are motivated to volunteer by social inclusion and adaptation to changes after retirement (Duan & Wang, 2010), social welfare programs (Duan & Wang, 2010; Shea, 2017), self-realization (Q. Li, 2010), and positive self-identity (Xie, 2015). However, there is sparse evidence on how volunteering influences the evolution of identity among older adults after retirement in urban China.
The rapid growth of the aging population and advocacy for elderly volunteering in China provides a valuable opportunity to explore how volunteering influences older adults’ identities. This exploration offers insight that can lead to culturally salient evidence in the face of an increasingly diverse and global society (Tang et al., 2009). Thus, the purpose of this study is to explore how older adults’ identity evolves through volunteering in the community in urban China.
Volunteering and Role Identity
Western scholars have long argued for volunteering as a mechanism for sustaining older adults’ role identity after retirement (e.g., Einolf & Chambré, 2011; Finkelstein et al., 2005; Hustinx et al., 2010; Thoits, 2012). Role identity defines and guides individuals’ behavioral, emotional, and psychological features; provides meanings in different contexts; and reflects individuals’ personal characteristics and their relationships to large groups (Goffman, 1959). Role identity also internalizes individuals’ social interactions and others’ expectations, which becomes a part of their self-concept (Callero et al., 1987; Finkelstein & Brannick, 2007; Lee et al., 1999). Role identity can change over the life course according to individuals’ age, profession, and environment (Serpe, 1987). The loss of professional identity in retirement has a profound impact on older adults’ role identity (Barnes & Parry, 2004; Damman et al., 2015).
Most existing studies in the Western context on how volunteering influences role identity rely on psychological, quantitative approaches (e.g., Dury et al., 2015; Finkelstein & Brannick, 2007; Marta et al., 2014; Van Dyne & Farmer, 2004; Van Willigen, 2000). These studies reveal that role identity is a significant predictor in sustaining volunteer behaviors and performance (Finkelstein & Brannick, 2007; Marta et al., 2014; Van Willigen, 2000). However, most findings have been based on relatively young samples, such as undergraduates (Finkelstein & Brannick, 2007) and young adults (Grönlund, 2011). Older adults’ role identity during volunteering has seldom been investigated. Furthermore, retirement constitutes not only an objective transition, but also a subjective adjustment process (Kim & Moen, 2002). Thus, it calls for qualitative approaches to explore how older adults’ role identity evolves during volunteering after retirement.
Volunteering and Social Identity
According to social identity theory, an individual’s self-concept consists of two parts: personal identity and social identity (Tajfel & Turner, 1986). Personal identity emphasizes an individual’s personal characteristics, such as self-meanings and self-categorization (Stets & Burke, 2000). Social identity is individuals’ identity as a member of various social groups. Individuals’ self-images are derived from various group classifications and related social and psychological categories, in which they perceive themselves as belonging (Tajfel & Turner, 1986). By comparing their group position with that of others, individuals categorize themselves to achieve a sense of positive identity (Tajfel, 1978).
Studies have found that volunteering strengthened older adults’ self-identity by improving health outcomes (Morrow-Howell et al., 2009; Musick & Wilson, 2003) and psychological well-being (Haski-Leventhal, 2009). Realizing self-efficacy and obtaining a sense of worthiness through volunteering also contributes to sustaining positive self-identity for older adults (Morrow-Howell et al., 2009; Thoits & Hewitt, 2001).
In relation to social identity, volunteers share a specific group identity (Cnaan et al., 2006; Haski-Leventhal, 2009; Haski-Leventhal & Cnaan, 2009), which unites them and reinforces their volunteering behaviors (Stets & Burke, 2000), prompting further volunteer activities and sustaining related norms (Haski-Leventhal & Cnaan, 2009). This shared group identity can also enhance volunteers’ self-identity (Stets & Burke, 2000). Xie (2015) found that elderly Chinese volunteers achieved more positive self-identity and younger subjective age than their nonvolunteer counterparts.
Volunteering and Identity Continuity
Our study also draws on continuity theory (Atchley, 1989) to explore how older adults sustained their identities through their volunteering experiences. Continuity theory posits that older adults prefer to use familiar strategies (e.g., attitudes, perceptions, preferences, and behaviors) to maintain existing structures—continuity—to adapt to the aging process (Atchley, 1989; Covey, 1981; Henning et al., 2016; Nimrod & Kleiber, 2007). These strategies accumulated during the life course create a cognitive stability for older adults to face obstacles posed by the aging process (Hoogl, 2015). Atchley (1989) further distinguishes between internal continuity and external continuity. Internal continuity refers to psychological statuses, including ideas, temperament, affect, experiences, and so forth, connecting older adults’ past with present self. External continuity refers to activities, roles, and people in the older adults’ familiar physical and social environments (Atchley, 1989; Nimrod & Kleiber, 2007). Optimal continuity for older adults means that their internal and external continuity allow them to adapt well to changes associated with their aging process (Atchley, 1989).
Continuity theory has been applied to examine the absence of role identity after older adults’ retirement (e.g., Haski-Leventhal, 2009; Henning et al., 2016; Nimrod & Kleiber, 2007; Payne, 1977). Henning and his colleagues (2016) found that the continuity pattern had long-term, positive implications for older adults’ successful adaptation to retirement. More specifically, Greenfield and Marks (2004) reported that volunteering can enhance older adults’ psychological adaptation, or internal continuity, to adjust to life after retirement. Haski-Leventhal (2009) found that long-term volunteering sustained external continuity for elderly European volunteers, who were more optimistic about their prospects for living longer than their nonvolunteer counterparts.
Method
Study Procedure and Sampling
Because life stories can help to address the process of identity construction and continuity (Grönlund, 2011), we took a qualitative approach to explore elderly volunteers’ role identities in Shanghai. We combined purposive and snowballing sampling strategies to recruit community-dwelling elderly volunteers. Participants’ inclusion criteria were (a) aged 60 and above and (b) active volunteers (i.e., volunteering at the time of the interview). After receiving ethical approval from the university, recruitment took place in one district in Shanghai. In each residential committee (i.e., an urban residential area and its residents administered by a subdistrict in China) of the district, local social workers introduced the research team to elderly volunteer representatives. We held five information briefing sessions to answer their questions and address their concerns. Then, we invited these representatives and their friends, neighbors, and relatives to participate in the study.
A total of 40 elderly volunteers (22 women and 18 men) participated in face-to-face, semi-structured, in-depth interviews. All participants were formal volunteers organized by residential committees and/or community-based, nonprofit organizations. Participants’ average age was 68 years old and ranged from 60 to 85. Most of them were long-term volunteers; over 80% had volunteered for more than 5 years. A majority of participants were married and lived with a spouse. Approximately 80% of participants were members of the Communist Party of China (CPC). Over two thirds reported medium to high income. Noticeably, 30% of participants also undertook family caregiving responsibilities while volunteering. Table 1 presents detailed demographic characteristics of the participants. Compared with the general Chinese aging population between 60 and 89 years in 2018, the sample tended to be older, richer, and had more females (National Bureau of Statistics of China, 2019). Participants volunteered in various programs and services in the community, including neighborhood watch, traffic monitoring, after-school programs for elementary students, and residential committees, and as legal consultants and leaders in various interest groups.
Demographic Characteristics of Participants.
At the current exchange rate, 1,000 yuan equals roughly US$140.
Date Collection and Analysis
All participants gave written informed consent. We began each interview with a grand-tour question about how participants began volunteering. Then we asked about their perceptions of volunteering and their volunteering experiences. Participants also shared how their family members and friends viewed their volunteering. Each interview concluded with participants’ speculations about the future for elderly volunteers in the community in Shanghai. Each participant was interviewed for 1 to 2 hr at their home or at a designated private room in the residential committee. Each interview was conducted in Mandarin or Shanghai dialect and was audiotaped with permission. Each interview was transcribed verbatim in Chinese immediately afterward.
All three members in the research team are proficient in both English and Chinese; we read through the Chinese transcripts first to have a holistic understanding of these elderly volunteers’ experiences. Then, we independently translated half of the transcripts into English (i.e., 20 each) and checked the translation for each other to ensure its validity. Noticeably, the goal for the English translation was to articulate the entirety of the story, especially the emotion, narratives, and experiences of participants, so it was not necessarily verbatim from Chinese.
The research team open-coded all the English transcripts and identified and extracted participants’ understandings, perceptions, and experiences from their stories. Codes and statements were then grouped into various categories based on similarity in description (Strauss & Corbin, 1998). Similar statements and categories were then grouped together to form themes (Guest et al., 2011). Themes emerged from recurrent categories pertaining to participants’ experiences, identities, and perceptions. The first and third authors identified categories and themes independently, and then compared them to reach consensus on all the theme definitions. The second author acted as “peer scrutiny” to protect the rigor and trustworthiness of the study at each stage of data analysis (Shenton, 2004). After identifying all the themes, the research team read through the original Chinese transcripts again to ensure that all themes were accounted for. We kept memos and discussion notes as an audit trail.
Results
Participants developed new career and community identities through volunteering. During the process, they sustained a continuity of professional and CPC identities. Most participants agreed that volunteering could protect their identities while some of them experienced negative results.
Volunteering as Identity Development
Volunteering as a new career identity
A majority of participants believed volunteering became their new career after retirement. Many participants referred to volunteering as their “smaller career,” perhaps indicating a devotion similar to the one they had had for their previous career. For example, 70-year-old Mr. Zhang (all participants’ names are pseudonyms) shared his experiences: I view volunteering in the community the same as my previous work in Civil Affairs. It’s my second job. I am glad that I can continue to do good for the society. I received the Shanghai Excellent Volunteers award in 2016. The mayor gave me the award! This is tremendously meaningful for me as well as for all the elderly volunteers in Shanghai.
Participants treated volunteering seriously as a profession after retirement. They were committed to continually contributing to society and striving for the common good.
Volunteering to foster a community identity
Most participants began volunteering in the community after retirement. Before retirement, they were not involved in the community. For example, 63-year-old Mrs. Mao admitted, I knew nothing about volunteering before I was retired. I did not participate in anything in the community. As I became involved in volunteering in the community 7 years ago, I increasingly identify myself with my community.
Participants identified with their fellow elderly volunteers and showed strong willingness to serve the community. For example, 85-year-old Mr. Wang generalized, “The more I volunteer in the community, the more I connect with other volunteers, and the more I consider myself a member of this community. That’s why I keep volunteering.” As their volunteering progressed, participants shared a growing attachment to volunteer groups and to the community.
Volunteering in different interest groups in the community, such as singing and calligraphy, became one of the most effective ways to enhance the identities of volunteers and strengthen their attachment to the community. Many participants volunteered as team leaders. For example, Mrs. Bai, 73 years old, shared her experience: I love our singing team so much that I began to voluntarily work as the team leader about 5 years ago. I have recruited many members from the community. [The team] meets twice a week, practicing for 2 hours. We were awarded the second prize in the District’s older adults’ singing competition last year. We were very proud of representing our community.
Volunteering in the community fostered a sense of belonging for participants and identification with volunteer groups. This understanding promoted participants’ contributions to the community, which became a new collective for them after retirement.
Volunteering as Identity Continuum
Maintaining a professional identity
A majority of participants felt anxious about losing their professional identities after retirement. Volunteering became an integral medium for preserving their work capacities. For example, 67-year-old Mr. Li, a retired physician who volunteered in the community free clinic for 7 years, said, “I am glad that I can still see patients as if I had never been retired.” Maintenance of professional identity preserved participants’ productivity, which they valued highly. They realized that their skills and professional knowledge were still useful. Such usefulness, in turn, encouraged them to continue to volunteer in the community.
Renewing a party identity
In this study, four fifths of participants were CPC members who believed that volunteering was an essential part of their party identity. For example, 66-year-old Mr. Ma said, I am a CPC member. I should comply with the oath when I became a CPC member, being a model citizen and striving for the common good. I contributed to the society when I worked in the factory. I believed I could continue to do so after retirement. This is not about age, but about CPC membership. So I contacted the residential committee right after my retirement and began to volunteer in the community. It has been over 6 years.
As CPC members, these participants were driven to pursue the common good and believed volunteering could help them to achieve this goal. Volunteering in the community became an opportunity for them to continue to pursue the collectivism underscored by the Communist Party. As such, these elderly CPC members were driven to fulfill the mission of the Party, in turn reinforcing their Party identity.
Volunteering as Identity Booster or Antagonist
Most participants acknowledged that volunteering strengthened their identities by expanding social networks and self-realization. However, prejudices from the younger generations during volunteering made participants feel rejected and repressed.
Identity booster
Volunteering maintained participants’ role identity and social identity, which further enhanced their self-identity. Volunteering proved that older adults could stay active in the community despite their growing age; this was particularly true for the old-old participants (i.e., 80 years old and over). For example, 86-year-old Mr. Tang, who had volunteered in a photography group for more than 20 years, said, “Although I stepped down as the group leader when I turned 80, I am still very much involved.” Volunteering helped participants stay socially engaged, which fulfilled and even exceeded the role that was expected for the general aging population.
Participants’ social identity was strengthened by expanded social networks during volunteering, which offered opportunities for them to connect with the younger generations. For example, 73-year-old Mr. Liu, who had led a gardening group for 6 years, said, Being old means being lonely, but I have made so many friends in the group. Some of my group members are high school students. Talking with them is a delight. I am catching up with the younger generation—see, I am using an iPhone.
Frequent contact with the younger generations motivated participants to stay socially engaged. Enhanced role identity and social identity helped raise participants’ self-esteem, which underpinned their positive self-identity. For example, 68-year-old Mrs. Ye believed that volunteering increased her self-confidence: I used to stay at home alone and seldom socialize. Volunteering pushes me to go out, to talk to people, and to be connected with other volunteers. Volunteering is for the common good, which makes me feel needed and valued.
As such, a reciprocal process emerged between identity maintenance and volunteering. Participants’ self-esteem and values were enhanced by volunteering, which in turn, encouraged their continued volunteering in the community.
Identity antagonist
However, volunteering was not always positive for participants. Some felt devalued when their volunteering efforts were not appreciated by the younger generations, who usually held the stereotype of older adults as frail and dependent. For example, 70-year-old Mrs. Wang recalled, “I almost gave up [volunteering] twice. Some young people in the community believe that we should go home and rest. They simply despise us. [I’m] very frustrated.” One third of participants undertook family caregiving while volunteering, which was difficult for them to balance. Mrs. Wang continued, I was even more frustrated about my family. My son used to say, ‘You’d better stay at home taking care of my father rather than volunteer.’ I managed both. Both are my commitment but sometimes volunteering outweighs caregiving because I love the community.
It was challenging for these participants to balance their family commitments with volunteering in the community. The younger generation’s stereotyping diminished participants’ enthusiasm and motivation to volunteer. These negative experiences lowered participants’ self-esteem and self-value.
Discussion
This study explored how volunteering in the community shaped 40 participants’ identities after retirement, including developing new identities and consolidating old ones. Although most participants believed that volunteering strengthened their identities, some of them faced challenges. These findings shed light on the sociocultural contexts of elderly volunteering in urban China.
Shaping Identities Through Volunteering
Role identity
Volunteering added roles and identities to participants’ retirement life (Sieber, 1974). Participants in this study experienced both role enhancement and role strain throughout the volunteering process (Rozario et al., 2004). Regardless of their old age, their role identities and activities continued to grow (Hoogland, 2015). Enhanced role identity motivated participants to achieve strong volunteer commitment and to maintain their volunteering behaviors (Van Dyne & Farmer, 2004; Van Willigen, 2000). Feeling useful through volunteering sustained their sense of accomplishment and self-realization. This brought psychological comfort to participants during their retirement transition (Kojola & Moen, 2016).
Increased intergenerational contact while volunteering also enhanced role identity for some participants. With higher levels of social and cultural capital, participants who led interest groups were eager to have contact with and leave meaningful legacies to the younger generations (Morrow-Howell, 2010). These intergenerational contacts may have helped reduce prejudice for participants (Allport, 1954), for example, age-based ones (Grefe, 2011). However, intergenerational contact alone is not sufficient to reduce age-based prejudice; for such contact to be effective, the different generations should have equal status, carry out meaningful and cooperative activities, and be recognized by a higher authority (Allport, 1954; Gonzales et al., 2010; Grefe, 2011).
Meanwhile, some participants experienced role strains when facing younger generations’ prejudice about their vulnerabilities and denial of their contributions as volunteers (Minichiello et al., 2000). Some participants had to adjust to role conflicts (Sieber, 1974), for example, between family caregiving responsibilities and volunteering. Balancing their priorities and time between volunteering and providing family caregiving could be complicated for participants. When family caregiving was not too demanding, older volunteers could contribute more to volunteering. When their family caregiving burdens increased, they retreated back home to fulfill their caregiving responsibilities. Although older caregivers who also volunteered reported better self-rated health (Rozario et al., 2004), the delicate balance between these two activities and its long-term implications need further investigation.
Social identity
Volunteering helped older adults reconstruct their social identities and bolster their independence (e.g., Q. Li, 2010; Morrow-Howell et al., 2009; Payne, 1977; Xie, 2015). Their sense of usefulness was internalized as positive self-identity to motivate participants to continue to contribute (Finkelstein et al., 2005). Their growing connection with community also became a new part of social identity for participants, which empowered them to seek a sense of belonging in the community (Warburton et al., 2007).
Furthermore, the group identity of volunteers consolidated group norms to reinforce participants’ volunteering behaviors (Haski-Leventhal & Cnaan, 2009; Hustinx et al., 2010; Nimrod & Kleiber, 2007). Participants increasingly identified themselves with other volunteers and with the commitment to volunteering. In particular, volunteering sustained CPC identity for participants. Their continual contribution to the community and the common good fulfilled the mission of being a CPC member (Xinhua News Agency, 2017). Both identities—being CPC members and volunteers in the community—motivated participants to carry on the mission of the CPC after retirement (Duan & Wang, 2010).
Identity continuity
Volunteering in fields related to their previous professions extended participants’ professional identities. Atchley (1971) argued that when postretirement activities have job-related components and skills, older adults are likely to adapt smoothly to retirement. To maintain an active professional identity, participants commonly chose to volunteer in the areas closely related to their previous professions, providing a foundation for external continuity (von Bonsdorff et al., 2009). This transition also sustained internal continuity by providing psychological comfort, alleviating their anxiety about adapting to retirement (Damman et al., 2015; Greenfield & Marks, 2004).
Sociocultural Context of Elderly Volunteering in China
Confucius’s philosophy of “yi(义)” laid the moral and cultural foundation for volunteering in China. This concept refers to a high moral responsibility to serve society and others of one’s own free will (Luova, 2011). To be considered a cultivated individual in the society, one should perform yi to help others outside of their own family (Ding et al., 2007; Luova, 2011). Yi becomes both a social requirement and a personal choice (Ding et al., 2007). Thus, participants in this study tended to choose formal volunteering over informal volunteering (i.e., family caregiving) to show their altruism for the community. In doing so, they fulfilled yi by going beyond kinship bonds and working for the common good, which likely prompted their potential and actual volunteering behaviors (Dury et al., 2015).
Another salient sociocultural context related to elderly volunteering is the Chinese government’s advocacy of community self-governance since the millennium (Bray, 2006). Volunteers from the local residential population are encouraged to assist with daily logistics for community self-governance (Bray, 2006). Led by residential committees and the local CPC Party Branches, elderly volunteers thus become indispensable for the community to create and develop support for its residents (Bray, 2006; Luova, 2011). Community volunteering activities are highly regarded because they can enhance both self-governance and CPC leadership on the community and home levels (Luova, 2011). The high proportion of CPC members (80%) in our sample also reflects the steadfast CPC leadership in the community.
Noticeably, the “self” in community self-governance should be “understood as a collective rather than an individual self” (Bray, 2006, p. 544). Participants in this study lived and worked during the most collectivist period of Chinese history (i.e., 1949-1979; Dahlman & Aubert, 2001). From the life course perspective (Elder et al., 2015), individuals’ life course experiences and social contexts affect their later life and how they perceive their aging process. In this study, volunteering in the community created an opportunity for participants to continue to express collectivist values and repay the community (Duan & Wang, 2010).
The findings of this study also indicate that formal volunteering in the community in China consists of various types (e.g., Liu & Lou, 2016), including work in the residential committees, various social activities, and interest groups, which are often grouped together without clear classification. Future practice and research can further distinguish how these different types of volunteering influence older adults’ identity, social networks, life satisfaction, and so forth.
Policy and Practice Implications
The increasing recognition of productive aging has contributed to reshaping the social discourse and policy agenda for the continuously rising number of older adults worldwide (Morrow-Howell et al., 2015). To transform role strain to role enhancement, policymakers should be aware of potential barriers to elderly volunteering (Warburton et al., 2007), such as younger generations’ negative perceptions of older adults’ volunteer activities and family caregiving obligations. Policymakers should cultivate a volunteer-friendly environment in the community as well as in the larger society. For example, policy agendas related to elderly volunteers in China should prioritize structural support for their preferences and expand volunteering opportunities (Mutchler et al., 2003). Community volunteer organizations should emphasize a “volunteers-first” philosophy to attract elderly volunteers’ involvement (Greenfield et al., 2016).
Social workers in the community should continue to encourage volunteering opportunities for older adults as an effective way to supplement their social engagement. They should emphasize the importance of social usefulness for older adults when developing and promoting volunteering opportunities. For example, relevant skill training, in-kind incentives, and well-organized educational and social opportunities should be emphasized (Hong et al., 2009; Narushima, 2005). It is important to continually recognize elderly volunteers’ contributions (Hong et al., 2009). Taking the Contact Hypothesis (Allport, 1954) into consideration, more intergenerational educational programming is needed to promote intergenerational integration of older adults. For example, elementary schools can invite elderly volunteers to share their stories and experiences with students. College students can partner with elderly volunteer groups to work in the community. As such, a more volunteer-friendly environment can further encourage the next generation of volunteering in the community.
Study Limitations
Several limitations should be noted. First, this study was cross-sectional. How long-term volunteering experiences influence older adults’ well-being and lives needs further longitudinal investigation. Second, participants were active volunteers at the time of interview. This may have resulted in a selection bias. Those who do not volunteer or who have stopped volunteering may have different views on volunteering, and these were not included in this study. Third, this study took place in Shanghai, which offers comparatively abundant volunteering opportunities across all ages. Our findings may not apply to other places in China where volunteering opportunities are limited. Other structural and institutional factors, such as incentives and different types of social organizations, need to be examined in future studies.
Conclusion
This study explored how volunteering in the community influenced and shaped older adults’ identities in urban China. Through volunteering, participants developed new volunteer and community identities as well as continued their professional and CPC identities. Although most participants agreed that volunteering enhanced their identities, some of them experienced conflicts that weakened their identities. This study offers insight on sociocultural nuances of elderly volunteering in urban China. It informs future Chinese policy development and social work practice to a cultivate volunteering culture and promote volunteering opportunities for older adults.
Footnotes
Acknowledgements
We thank all the elderly volunteers for participating in our study and sharing their stories with us. We also appreciate all the comments and suggestions received from three anonymous reviewers and editors.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
