Future care preparation profiles and self-support ability among rural Chinese older adults: a cross-sectional study

Population aging is accelerating worldwide, and rural older adults may face particular challenges because of limited access to formal care resources. Preparation for future care (PFC) is a multidimensional process involving awareness, avoidance, decision-making, and concrete planning. This study identified latent PFC profiles among rural older adults in China and examined their association with self-support ability.

A cross-sectional survey was conducted among 851 older adults from 16 rural villages in Hebei Province, China. Data were obtained using a general information questionnaire, the 14-item Preparation for Future Care Needs Scale, the Self-supporting Ability Rating Scale for the Elderly, and the Generalized Self-Efficacy Scale. Latent profile analysis used the four PFC dimension mean scores as continuous indicators. Independent-samples t tests or one-way analysis of variance were used for univariate comparisons, followed by multiple linear regression.

Three PFC profiles were identified: scarce-preparation (23.97%), moderate-preparation (47.00%), and high-avoidance/high-action (29.03%). In the adjusted model, marital status, family members' health status, self-efficacy, and PFC profile membership were significantly associated with self-support ability. Compared with the high-avoidance/high-action profile, the scarce-preparation profile (B = -52.874, p < 0.001) and moderate-preparation profile (B = -31.296, p < 0.001) had lower self-support ability scores. Self-efficacy was positively associated with self-support ability (B = 2.519, p < 0.001). The model explained 64.0% of the variance in self-support ability.

PFC among rural older adults is heterogeneous, and high avoidance can coexist with active care preparation. The action-oriented components of preparation may be particularly relevant to later-life autonomy. Profile-informed, family-sensitive, and community-based approaches warrant further evaluation in longitudinal and intervention studies.