key: cord-1023386-zoetjr3w authors: Ren, Puxiang; Emiliussen, Jakob; Christiansen, Regina; Engelsen, Søren; Klausen, Søren Harnow title: Filial Piety, Generativity and Older Adults’ Wellbeing and Loneliness in Denmark and China date: 2022-04-21 journal: Appl Res Qual Life DOI: 10.1007/s11482-022-10053-z sha: 657ffb508c2f5ef4cc56b221cb76b762ba085127 doc_id: 1023386 cord_uid: zoetjr3w The article considers the potential of intergenerational encounters and family and social ties for alleviating loneliness and promoting older adults’ wellbeing. Loneliness has been widely recognized as one of the factors that are most deeply and pervasively detrimental to older adults’ wellbeing. We combine theoretical reflections with a comparative study of older adults in Denmark and China. Both countries have to deal with an aging population and growing number of cases of isolation and loneliness in an increasingly individualized society. They differ, however, with regard to how far they have developed a system of institutionalized care, as well as with regard to their culture-specific views of family life and parent-child relationships. We apply the notions of filial piety, known from Confucian philosophy but often misinterpreted as conservative and conformist, and generativity, to qualitative studies of older adults in Denmark and China. The great potential of intergenerational ties is confirmed. Our study also shows that filial piety is still highly valued, in both China and Denmark, and can be maintained even in a highly individualized society. There is, however, considerable uncertainty among both older adults and their younger relatives as to what is required and what can be expected; realism, and an emphasis on the quality, rather than the quantity of interaction, may be sensible coping strategies, but can also lead to unnecessary acquiescence and self-abnegation. Our study also serves to distinguish different aspects and effects on wellbeing of intergenerational relationships. Loneliness has been widely recognized as one of the factors that are most deeply and pervasively detrimental to older adults' wellbeing. Modern theories of psychosocial development and ancient Chinese philosophy both give reasons to expect that intergenerational encounters and close family ties may help to alleviate loneliness and provide older adults with a sense of living a meaningful and satisfactory life. In this paper we combine theoretical reflections with a comparative study of older adults in Denmark and China. Both countries have to deal with an aging population and growing number of cases of isolation and loneliness in an increasingly individualized society. They differ, however, with regard to how far they have developed a system of institutionalized care, as well as with regard to their culture-specific views of family life and parent-child relationships. We will focus on the Confucian concept of filial piety and the modern idea of generativity, asking whether and how they might contribute to alleviating the problem of loneliness among older adults. Our study also serves to distinguish different aspects and effects on wellbeing of intergenerational relationships. While the notion of filial piety comprises a wide variety of attitudes, practices and obligations, and has often been associated mainly with rituals, conventions, material support and care, we will focus especially on the dimension of emotional ties and emotional support. We do so because we are targeting an emotional predicament, viz. loneliness, but also because we take the Confucian notion of filial piety to be at root more about attitude and emotional bonds than outward reverence or material support (see Sung, 2001 for similar observations), and not least because the emotional and qualitative aspects were strongly emphasized by the participants. We also note, however, that emotional and practical aspects of care are often intertwined, and that the apparently one-sided emphasis on emotional bonds comes with certain qualifications. 28% in a study by Luo and Waite (2014) . On the other side of the earth, evidence from recent studies shows that 10 to 20% of the elderly in Northern and Western Europe suffer from loneliness (Hansen & Slagsvold, 2016) ; and in another study comprising of 767 older adults, 17.9% aged 65 years and above reported feeling lonely (Due et al., 2017) . These figures make clear that loneliness knows no borders nor differentiates between nations. Some have claimed that the problem is due to the insufficient care systems provided by the state for its citizens (Jackson & Liu, 2017) , but the figures indicate that countries with advanced care systems do not fare significantly better. 1 Loneliness has been found to be associated with social changes. In China, the availability of the traditional family all-round care, of which the Confucian notion of filial piety (xiao 孝) is the pillar -children are obligated to live with and take care of their aging parents (Chu et al., 2011) -is significantly influenced by social transitions which has been attributed to the one-child only policy, the decline of the family household structure, and increasing migration and urbanisation (Liu, 2017; Zhang & Goza, 2006; Cheung & Kwan, 2009) . A rising sense of individualism, particularly in the younger generation, coupled with a significant increase in life expectancy in the older generation (Jackson & Liu, 2017) , has resulted in a disproportionate decrease in the availability of family care (Flaherty et al., 2007) ; the family may not be able to provide the necessary support for older adults. Yet families remain the primary source of welfare and support to the elderly in contemporary China, with support from the state care system usually seen as the last resort (Shang & Wu, 2011; Lin, 2014) . Along with these changes, what is perhaps more distressing for the older adults is the emotional negligence that they can encounter from their adult children. According to Lao et al. (2019) , adult children often consistently refuse to visit parents living in care homes, some even leaving periods over one year between visits. As such, a deeper cause behind the emergence of loneliness in the older adults may be the weakened emotional connection between them and their adult children in the traditional family care unit and a certain "numbness" among people in the homogeneous and standardized state care system, which has come about as a consequence of modernization. A public care system can be seen as double-edged sword which can be leveraged equally for good or evil. Aging alone in the homeplace or in state care homes are the two distinctive alternatives for older adult care in western countries, and this is also a growing tendency in China. Several recent studies show that the proportion of older persons living alone is steadily increasing world-wide (UNPD, 2013; UN, 2017) . This is an understandable norm in the context of limited family care provision, or at least, where there is no necessity for immediate care. Some hold that aging in the home might increase the opportunity to engage with friends and family, whereas others suggest that it might be a source of negative experiences of loneliness and social isolation (Evans, 2007) . Making older adults live at home as long as possible is preferable for policy makers, at least from an economic point of view, as it significantly reduces the cost of health care if the elderly opt out of institutional care (Sixsmith & Sixsmith, 2008) . In addition, those living in care homes score higher in terms of depression and hopelessness than those living at home (Ron, 2004) . Some form and degree of institutionalized care is clearly unavoidable in modern societies; the question is whether and to what extent loneliness among the elderly is also unavoidable. Institutionalized care is usually good at satisfying basic practical needs, whereas it may be less good at supporting older adults' emotional and existential wellbeing. It also adheres to the principle of universalism. This might make it less well suited for addressing particular conditions and experiences, which are presumably important factors in loneliness and depression. According to Klein et al. (2017) , older people without a partner, and living alone without children, exhibit a greater degree of loneliness than others. In contrast to this, in familistic cultures, people tend to emphasize and expect strong ties within the family and community. One might assume that such cultures prevent loneliness by promoting social integration. A similar assumption is supported by the notion of generativity that was coined by Erik Erikson as part of his psychosocial theory of personal development. Generativity refers to a special concern for younger people and felt need to contribute to the next generation, which develops during middle age and becomes stronger as the person grows older (Erikson, 1997). 2 Seemingly, there are differences between the notions of filial piety and generativity, as the latter also includes a concern for the younger generation beyond one's own family, and the emphasis is on how older people care for the younger, rather than the other way around. Yet both filial piety and generativity obviously entails a mutual relationship (see below), as older people can only take part in the lives of the younger if they are given the opportunity to do so, which requires attention and respect from the young, and not least from the children. Studies of the influence of family relations on older adults wellbeing have been relatively sparse in Western countries, probably because they do not match the dominant values and assumptions -e.g. that authentic and existentially satisfying emotions are not essentially related the parent-child relationship, but instead belong to marriage, sexuality and friendship (Giddens, 1992; Gabb, 2008; Jamieson, 1998 Jamieson, , 2011 , or that close family ties and obligations are an obstacle to individual emancipation and self-realization (though the notion of generativity has inspired a number of empirical studies, e.g. McAdams et al., 1993; Pratt et al., 2008; Villar, 2012; Ehlman & Ligon, 2012) . By contrast, there is a large volume of Chinese literature that touches upon this topic. In Chinese familistic culture, Confucius' core principle "filial piety (xiao 孝)" serves as a norm for the relationship between older adults and their adult children. To Confucius, the mere core of parent-child love is based on a mutual relationship, in which the love from the parent to a child comes naturally and does not have to be learnt or taught; likewise it is obvious when observing little children that they show a special affection for their parents. This natural biological bonding, however, tends to be gradually withered away as the children grow up and are then in pursuit of their own independence, and their focus shifts to the needs of their own children, rather than caring for their parents (Ni, 2010: 80) . Furthermore, from a biological perspective, filial piety is not necessary for the evolution of the human species (Ni, 2010: 80) . That the natural basis is not strong enough to ensure filial piety may be a main reason why Confucius underscored this notion. According to him, the essence of filial piety is human-heartedness (ren 仁), a matter of personal life and attitude, rather than of social norms of natural inclinations. As noted in the introduction, we have studied filial piety mainly in the context of emotional support, and we have focused on co-residence and keeping company. We do take emotional support to be central to the very notion of filial piety, as we interpret it (see sections 4.iv and 5 below), and its importance was strongly confirmed by our findings. The participants were being asked about keeping company, visits from family members etc., and most of them were living alone or in a care home without a partner or other family members, which may have tended to make the topic of coresidence particularly salient. However, without being further prompted -see below on the bottom-up approach to data collection -the participants almost uniformly pointed to the importance of emotional ties. The present study compares Denmark and China for several reasons. First, Denmark is widely regarded as having established one of the most admirable and perfected state care systems in the world, while China is still in the process of developing such a system. Secondly, they represent markedly different perspectives on family life and parent-child relationships. In China the ideal has been a holistic, harmonious and close-knit relationship among family members, centered around parents, couples and children, with an expectance of mutual concern (parents showing kindness to children and children respect for their parents). In Denmark the ideal relationship appears more restricted and one-sided, centered on couples and small children, with few or any responsibilities of adult children towards their older parents. Moreover, the prevalence of loneliness among older adults in Denmark and other Western countries with an advanced state care system might serve as a cautionary tale to those who are still struggling to establish one: apart from perfecting the care system, what else can be done to help alleviate loneliness and otherwise support the immaterial welfare among older adults? Finally, but not least, we would like to take seriously the possibility that the high expectations associated with strong family ties may increase feelings of loneliness if these expectations are not met (Johnson & Mullins, 1987; Jylhä & Jokela, 1990; Silverstein et al., 1996) . Placing a high value on close family ties may accentuate feelings of loneliness in older adults in countries with high rates of widowhood, decreasing fertility rates etc. (Flaherty et al., 2007) . Some might think that findings from Western and Non-Western countries are not comparable, because of the different cultural contexts and social background knowledge (Yan et al., 2014) . We agree that these factors are crucially important, seeing them as part of what needs to be studied rather than obstacles to comparative studies, but think that a mixed-methods-, but predominantly qualitative approach enables us to take them sufficiently into account. Our study is methodologically complex and unconventional. It is based on qualitative data collected by ourselves and student assistants in the context of two other studies of wellbeing of older adults in Denmark, and on the findings of a number of similar Chinese studies as these have been described in research articles and reports. Due to the Covid 19-pandemic, we were not able to carry out a parallel interviewbased in China ourselves, as had been originally planned. We are aware of the shortcomings of this asymmetric methodological approach. It can be justified, however, by the fact that there is a greater abundance of extant studies from China; hence what we do is mainly to measure and test our original findings from the Danish studies against existing knowledge about the Chinese case. Moreover, the Chinese studies on which we rely are based on very similar data collection and analysis methods. Perhaps most importantly, the Chinese publications contain extensive quotations from the interviews. While all the studies on which we base our analyses are characterised by a bottom-up approach, with semi-structured interviews and open-ended questions, one of the two Danish studies targeted the wellbeing of older adults during the Covid-19 pandemic, and this particular context is likely to have prompted a special focus on loneliness and the role of social and intergenerational contacts. As for the specific research designs, the first Danish study (Klausen et al., 2020) consisted of a total of 31 semi-structured interviews conducted with care recipients, care workers, relatives and managers from five municipal eldercare units (comprising both resident and home care); the present study uses the interviews with care recipients (5 in total). The group-specific interview guide was developed by the research group based on preliminary impressions from field observations at the care unit. The second Danish study consisted of 17 interviews conducted with older adult (64-97 years old) with different backgrounds and in different living arrangements, including three in residential care. Each interview (in both studies) lasted between 30 and 60 min, were recorded and fully transcribed. Both studies were inspired by Interpretative Phenomenological Analysis, a methodology designed to explore the specific experiences of participants in the given context (Smith, 2009 (Smith, , 2015 . Transcripts were closely read several times, notes were made from these, and emergent themes identified based on the notes. The analysis was informed by our special interest in intergenerational relationships and loneliness. While IPA also has a "hermeneutic" aspect, recognizing the active role of the researcher in making meaning comprehensible by translating it and encouraging the application of psychological concepts (Pietkiewicz & Smith, 2014) , we are aware that our analysis may have been hypothesis-and concept-driven to an extent that is not typical of the IPA method. It should be noted, however, that not just the analyses but the participants' own descriptions matched the philosophical and psychological notions very closely, in some cases almost verbatim. Hence the use of theory did not, in this case, involve any substantial reconstruction or represent an 'etic' or outsider-, as opposed to an 'emic' or insider-, perspective. The language and emphasis of the theory seemed to be continuous with the language and perspective of the participants. On the other hand, the present study should not be seen as one-sidedly empirical, as it crucially involves the interpretation and application of philosophical notions. On the Chinese side, we have made most extensive use of Lou and Ng (2012) , who conducted semi-structed interviews with 13 older adults living alone. Data were analysed using a "hermeneutic" approach; as in the first of the Danish studies, interviews were supplemented by field notes. The study of Zhang et al. (2019) , which we use more marginally, consisted in interviews with 10 older adults with mild to moderate dementia and 14 family caregivers; it also employed Interpretative Phenomenological Analysis. Lou and Ng (2012) conducted their study in Hong Kong; while there may be some differences as to the pace and level of modernization, and even to cultural background, between Hong Kong, Taiwan (which also figures in the broader literature we have drawn on) and mainland China, we will allow ourselves to ignore them and treat all the studies as uniformly Chinese. It should be noted, however, that the evidence from China comes mainly from a metropolitan, and even cosmopolitan, area (Hong Kong), where the transformation of values, including the meaning of filial piety, is likely to have been much more thoroughgoing than in rural China. 3 Hence we do not make a comparison between Denmark and China in general, but only between the urban and more developed parts of China and Denmark, focusing particularly on areas where individualization has already taken place. Since a large part of the population in China still lives in rural conditions, 4 and individualization may not have gone very far even in many urban areas, we do not take our findings to be representative of the Chinese population as such, nor do we make any claims as to the prevalence of particular living arrangements. We are interested in filial piety and generativity under conditions of individualization. This is important because the trend towards living alone is significant, anyhow, 5 so the case of urbanized, more or less individualized Chinese has exemplary value. A very pervasive theme that emerged in all parts of our study was that intergenerational relationships do seem to be a central factor in older adults' wellbeing. First, in the Danish studies, the participants often answered questions about their own current wellbeing by referring to their former life and accomplishments, including not least their family life, to the present situation of their children and grandchildren (how well they were doing at the time; what had become of them), and to how much contact they had to them (the frequency of visits etc.). An 82-year-old male insisted on sharing his view of his personal happiness, which he saw as consisting in "having chosen the right path", with respect to both work and marriage (the latter "no less than two times!"). A 102-years old female care resident, Gudrun, also spontaneously emphasized what family life had meant to her, and also pointed to the death of a son and the serious illness of another as events that could still disturb her otherwise positive outlook. Reminiscing about treasured life episodes with her adult daughter contribute greatly to lifting Gudrun's mood. Even a 64 old male, who described himself as having deliberately chosen to live alone, and as not being lonely, but just "being myself", nevertheless defined happiness as "an ordinary, good life … in which one is together with one's family or friends …". Secondly, the interviews made during the Covid 19-pandemic showed that it matters to older adults, and to their sense of wellbeing, how much it seems to them that they are cared for or recognized by the younger generation in a more general, not necessarily personal way. Carelessness among the younger generation -behaviours that put others' health, especially that of the oldest, at risk -or a lack of awareness of the sacrifices made by the older generation in order to maintain public health and keep society working, was perceived as a source of irritation that added significantly to their predicament. On the other hand, getting a sense of contributing to a good, transgenerational cause (and being recognized as such) served to mitigate the negative effects of being isolated, changing the feeling of loneliness into an experience of being alone in more meaningful, implicitly connected and thus more bearable way. This may have less to do with filial piety as such but highlights the importance of generativity (and see below (v.-vi.) on mutual respect as an element in filial piety, and the intertwining of aspects of filial piety and generativity). The Danish participants -especially the oldest ones -were keen to play down the importance of receiving attention from their Children, though not seldom these remarks sounded not as if they did not really want such attention, but rather as an attempt of coming to terms with what they considered inevitable, anyhow, as well as reflecting a moral obligation to not being a burden to one's children and not to interfere in their lives and decisions. This supports the assumption that older adults in Denmark subscribe to individualist values. But the ambivalence as to the actual consequences of individualism also shows that it is not perceived as unproblematic. Chinese culture is assumed to be more familistic and less individualist (see e.g. Lou et al., 2008) . Yet it has been noted that it has also become more individualist in recent times, (Chow, 2009; Yan, 2009) , not just leading to increased neglect on part of the children, as mentioned above, but also making parents increasingly concerned about not burdening or interfering with the lives of their children, not unlike the attitude found in older Danes. Quantitative studies have shown that the older generation now expect even less filial concern from the younger generation than the latter expect themselves to provide (Hsu et al., 2001; Cheng & Chan, 2006) . In contemporary Chinese society, this seemingly weakened relationship between older adults and their adult children, in terms of intergenerational support and life satisfaction, is more pronounced in urban areas than in rural parts, which chimes with findings in Wu (2021) that there is a rural-urban divide. It does not, however, seem to strongly influence the role of cultural norms (in particular that of filial piety) in moderating the effects caused by modern developments. This is consistent with existing research (Yuan et al., 2021) showing that older adults still expect care and attention from their adult children, and that various kinds of intergenerational support, like, co-residence and daily care, do contribute to their well-being. Traditional understandings of filial piety, such as perpetuating the family lineage of male heirs and assuming financial responsibility, may have transformed partially, due to a transition in economic structure, into more reciprocal forms (mutual understanding and respect -see v. below), in the current Chinese society. A widowed 77 years old Hong Kong woman, revealed in an interview that she preferred living separately from her married daughter because this could bring "freedom" to her and she could thus avoid potential conflicts with her son-in-law: I don't know whether my son-in-law would like to live with me or not. Maybe he likes me today; but who knows what will happen tomorrow (Lou & Ng, 2012, 10 ). An older male confessed that now I have limited expectations toward my children. We had tea gatherings several times a year. I feel satisfied. They are all busy and have their own life (Lou & Ng, 2012, 10 f.) Especially the reminder that children are busy and have their own, assumedly more pressing, concerns, closely echoes views uttered by the Danish participants. The examples also show how older Chinese try to form "realistic" -that is, moderate -expectations as part of a coping strategy, adapting to the new situation brought about by societal changes (Lou & Ng, 2012; Klausen et al., 2022) . Still, there is ample evidence that a lack of attention from the younger generations can feel painful even among the assumedly more individualist and thoroughly adapted Danes. Ketty, a 75 old female, serving herself as a voluntary aid in eldercare, describes it like this: Because if you are older and sit at home, then you go to pieces … that is the problem when you get older … your children have children, and then their children have children too. And then they get busier, and then their children busy as well, like it was for us. There are some older people for whom it happens really fast, bang! -then they are not in focus anymore. They feel marginalized ["driven out on a siding "]. This points to disappointment rather than easy acceptance, and to the difficulties of adapting, especially to sudden changes. Helle, a 86 old female repeatedly says that she "won't complain" about the infrequency of visits and phone calls, acknowledging that "people have enough [to do] nowadays", but also clearly describes the phone calls as being sometimes too few and answers evasively when being asked if she is satisfied with the contact she presently has to her children. One of the participants who most emphatically pointed to visits from his children as a central key to his own wellbeing, 68 years old John straightforwardly answered "yes" when asked if he would like to see them more often. In both groups we thus find a tension between an objective, "rationalized" notion of a satisfactory life, corresponding to what one could (and ought to) reasonably expect; and a more subjective, reflecting how far one is really satisfied, and how one would really like things to be. We also find a tension between individualist and more familistic or communitarian values. Interestingly, we find in the Chinese an increased sense of moral obligation from the parents towards the children, which probably also reflects the changing social circumstances, viz. an awareness that children have careers to tend to and face competition and uncertainty, and that their own children and intimate relationships may require more attention from them. A 65 years old female said: I don't bother my children with my problems, and I feel very satisfied with this (Lou & Ng, 2012, 12) . She gained wellbeing from her sense of shielding her children from potential worries, not unlike the satisfaction gained by older Danes during the Covid 19-pandemic from knowing that they were not burdening, but rather helping the rest of society. This attitude might seem to differ from what is implied by the notions of filial piety and generativity, but it can also be seen as an adaptation of these notions to new roles and circumstances (see the discussion below in Section 4)). In spite of the apparent tendency in older Danish adults to not (wanting to) expect much from their children and grandchildren in terms of concrete, personal interaction (visits; observance of care duties etc.), it emerges clearly from the studies that such interaction is in fact valued very highly and perceived as crucial to alleviating loneliness. An older male, Jens, emphatically asserted how glad he was when he received a (rare) visit from his children and his grandchildren, even though the grandchildren could be irritatingly noisy; he explained the rarity of the visits with the fact that his son-in-law has a foreign background: … well, I don't really know. I tried to quiet them [the small grandchildren] down. While Jens obviously values (and sincerely misses) the actual visits, he also indicates that what he wants most is the concrete manifestation (or "proof") of attention in the form a visit, and the opportunity to see his grandchildren (as well as being kept informed about their life), whereas he experiences the interaction with the grandchildren as challenging. Others likewise indicate that brief encounters can make a large difference. A 72 years old female tells that during the Corona crisis, she nevertheless managed to visit her daughter, "where we sat outside and had coffee, and sat a large distance [from one another], and it was nice enough to just … see the grandchildren. A pervasive theme in the Covid 19-related study is that the lack of physical contact -as the older adults are no longer allowed to hug their children and grandchildren -is perceived as a serious loss. We also found several examples in the study of older adults receiving institutionalized care that help with practical tasks, like ironing clothes or getting around, is also valued as a tangible proof of concern and attention. Rita, a 85 years old female receiving care at home, said that "It's so nice of the children, all three of them, to come home and accompany us when we need to go shopping for groceries once a week. And we need to go to the hospital to get checked up on, and when [my 91 years old husband] needs to go somewhere (he has a pacemaker), they drive here and pick him up and get him where he needs to go. We can't say anything else about them (the kids), other than that they help us a lot, even though they have their own kids to look after too." By looking closer at the examples that show the importance of physical contact and practical help, we come to see that it is not so much about the quantity of interaction, and still less about the solving of actual practical task (despite in some cases, the participants associate the meaning of being filial with family togetherness by reflecting in daily interaction). The latter could in many cases have been solved just as well, or even better by professional caretakers (though there are significant examples, also in the Danish findings, that the institutionalized care system is not able to identify or meet all the practical needs, and that older adults receiving regular support from there relatives can be better off also in a material sense, for example when it comes to mobility). Chinese studies likewise indicate that urbanization and growing affluence has shifted filial expectations from material and everyday practical assistance to emotional support (Hsu et al., 2001; Cheng & Chan, 2006) . The main point of the visits and practical activities, as described by the participants in our studies, is to maintain and demonstrate an emotional bond between the older adults, their children and their grandchildren (in some cases also reaching beyond the family), and to leave in the older adult a lasting impression of, and certainty about, this bond. There is a marked tendency in both the Danish and Chinese older adults to not wanting their children to keep in touch just because they feel obliged to. They crave for authentic engagement. This is in part explained by the theory of socioemotional selectivity, which suggests that, as time diminishes, the elderly have an increased need for meaningful and emotionally significant experiences and events, rather than for the material and instrumental goals that become dominant in late adolescence (Carstensen, 1992) . More importantly, this is in accordance with the original notion of filial piety (xiao 孝), which connects it closely with the notion of "human-heartedness" (ren仁) (e.g. (Analects 7 1.2) and sees it more as an indicator of a fundamentally good character and attitude than a formal obligation or prescription of specific actions (see further in the discussion below (Section 4)). This theme also indicates that filial piety is not only a traditional Chinese notion entrenched in Chinese society, but reflects an emotional need embedded in human nature, which may have become more manifest in recent generations of older adults. While older adults may be careful not to demand or expect too much, there seem to be an increased desire for an authentic emotional bond with adult children. A divorced 65 years old female told, with marked enthusiasm, that the Covid 19 pandemic had served as a test of the depth and sincerity of her children's feelings toward her, and was thrilled to notice that they had passed the test, and that the otherwise difficult situation had helped them to concentrate the interaction on what is most important, and engendered a new directness and informality: "There are not so many -reservations now. That genuine filial piety is associated with an appropriate mindset was also shown by Jens (see above), who hoped to have more contact with his grandchildren "later on, when they have become a little smarter [or "wiser"] . Maybe they get wiser with time. This both expresses a notion that one needs to understand and for oneself the value of intergenerational encounters, and a sense of generativity in that Jens wished to become a genuine part of his grandchildren's life and thoughts. The older adults want the interest to be driven by genuine concern for them as persons. It has been pointed out that in China (and perhaps still more in Western countries) "a new logic of intergenerational exchange" operates under a dynamic that "if parents do not treat their children well or are otherwise not good parents, then the children have reason to reduce scope and the amount of generosity to the parents" (Zhang, 2009) . Older adults seem to be acutely aware that the relationship should not be based on reciprocal benefits (and still less on "tit for tat"-thinking), and strongly averse to this logic. A study of intergenerational relationships in contemporary urban China by Kuan (2015, 149) suggests that the parent-child relationship can be more authentic "by removing expectations of payout and return, by removing the pollutions of economic behaviour", a point that could be said to reflect Confucius' golden rule: "To act with an eye on profit will incur a lot of complain" (Analects 4.12)). However, there is at the same time a sense (evidenced by the Danish studies) that more interaction, and especially more authentic interaction, could be beneficial to all involved, and so that the children and grandchildren would gain from it as well -though the "currency" is in this case emotional, rather than material (viz. subjective wellbeing). Ketty (see above) underlined that she got much satisfaction out of voluntarily helping the still older and weaker members of her community, sharing in their experiences and needs. This again tallies with the notion of filial piety: it is not about acting out of formal obligation, but rather about finding authentic pleasure in doing one's filial (and in this case civic) duties. Similarly, those receiving care are especially keen at ensuring that their children are seeking contact because they like to. 102 years old Ada was pleased to tell that "(…) My daughter gladly comes along. And if she sees something, e.g. a play at the theatre advertised in the newspaper or something like that, she'll ask me if we should go and see it." Ada takes pleasure both from the joy she perceives in her daughter and the fact that her daughter spontaneously suggest that they should do something together. It was similarly revealed in an interview with an old man with dementia in China that this "togetherness" appears to entail a sense of security: "I have one son, he is filial. He would send food and other stuff, whatever I need. I have no daughter. He buys clothes for me whenever he sees others wearing things that might suit me." (Zhang et al., 2019) , 2625. This is consistent with Nel Noddings' notion of care, understood as an attitude which is entrenched in the needs occurring in a particular personal relationship, and which is recognized and appreciated by the receiver as caring (Noddings 1984, 30) ; the person cared for must be "received not by formula, but as an individual" (Noddings 1984, 47) . Thusly understood, care is not provided by simply following rules for action, as the central need may not be met in this way. Authenticity also seems to matter when it comes to how older adults deal with their needs and expectations (see ii. on tensions and ambivalences). Although parents increasingly crave emotional bond with their adult children, it seems that they often have no idea of how to turn this emotional need into actual practices and behaviours. They also seem prone to suppress their emotional needs or even feeling shameful about them. This could be said to indicate that they fail to be authentic to themselves, not really understanding or identifying with their own inner experiences and values (Taylor, 1992; Klausen, 2018) . But it should also be noticed that this apparent inauthenticity is driven by a genuine (albeit perhaps misguided or exaggerated) concern of the parents for their children -and that maintaining, and standing by, the importance of emotional bonds between parents and children can be difficult under contemporary societal conditions. Quantitative studies from China indicate that the aspect of filial piety that is most consistently important to older adults' wellbeing is respect (Cheng & Chan, 2006) . This tallies with the original Confucian notion, that stresses not only respect but reverence: "Nowadays being filial is taken to mean only material support for one's parents. But even dogs and horses are supported in that way. Without reverence, what is there to mark the difference?" (Analects 2.7, compare also Sung, 2001) . As the contrast with material support shows, reverence is also understood as being a matter of attitude and emotional bonding, rather than fulfilling specific obligations; moreover, it does not signify a hierarchical or one-way relationship, but rather one of mutual respect. And mutual respect may, with Taylor (1992: 49) , be seen as entailing a sense of mutual understanding that is based on "equal recognition" of each other. An interesting example from our studies that illustrates how respect is more about understanding each other as persons, and less about acting in accordance with traditional norms and expectations, was given by a care home manager. She recounts how the son of a retired doctor, who had used to be dressed impeccably, was shocked by seeing his father, who had recently suffered a stroke, now sitting in his wheelchair in jogging pants and a loose shirt. "… but he didn't need a suit now, it would have been very uncomfortable and impractical … [the son] didn't understand that his father needs now were different. The care home manager made a connection between respect and authenticity, as she took it to entail an openness towards and acceptance of the other person as such, as well as an acknowledgement of one's (e.g. the child's or caregiver's) own limited knowledge and resources. She saw it as a lack of respect for the older citizen if carers believe that they know everything already, and a sign of respect to let the older citizens talk and decide for themselves. She also saw respect as a key to maintaining wellbeing in the care home residents: "it's … because you respect them as the beings they are … if you can meet them where they are, they actually get a lot more positive. This again is consistent with Noddings' (2002: 60) observation that people tend to concentrate too strongly on culturally shaped and superficial needs, overlooking the more authentic or deeply rooted ones. That a perceived lack of respect from their children can have a strong impact on the wellbeing of older adults, also in Denmark, is illustrated by a case shared by the manager of a public home care service. "There's this woman, in her mid-70's, whom her daughters got to move from the harbour and uptown … she hasn't been outside for quite a long time, and I think that she actually didn't want to move and that she's angry over having been moved. She's getting thinner, she doesn't eat anything and doesn't take her medicine. So her daughters are extremely worried. But she simply does not want us [from home care service] to come and help. She simply does not want it." This may of course be evidence of problems and mechanisms other than a lack of respect. 8 The very experience of leaving her familiar environment may also have been a significant cause of the woman's negative reaction; though the manager did seem to think that she was dissatisfied with being treated paternalistically. The case also indicates that the woman has preference for assistance -and genuine understanding -from the woman's own children, over the institutionalized and standardized care she has been offered. The importance for wellbeing of respect from the younger generations in a more impersonal, general sense was also underlined by the participants in the study of older adults during the Covid 19-pandemic, whose wish for being acknowledged as vulnerable, and for responsible health behaviour, seemed to express a concern for more than just their physical safety. It emerges from our studies that the different dimensions, aspects and manifestations of filial piety and generativity are intertangled and mutually enhancing. Emotional bonds are demonstrated and maintained by practical actions and face-to-face contact. Respect requires and is fuelled by understanding and authentic emotions, and so on. As implied by the notion of generativity, there is evidence that emotional bonds can be established through a variety of intergenerational interactions. 86 years old Helle told about bonding with her grandchildren and its effect: "the twins … one of them has a handicap, she recently had surgery again … I have been babysitting them a lot. You form kind of a relationship with them. It is also them who visit the most … they were also there when my husband [who suffered from dementia] passed away. They had to. … They took it quite easy, but then they have also taken part in the life we have had, since lived so close by. They came along and visited him, for that's what they had to. This again echoes the interpretation of Confucius' filial piety by Ni (2010) , that "the seed of filial piety exhibited in little children's affection toward their parents can wither away if it is not nurtured by education and cultivation". People tend to forget the importance of the intergenerational bond as they grow up, hence it needs to maintained and reinforced. The example demonstrates that the cultivation may start with very simple ways of making contact and forming habits. As Sarkissian (2010) notes, for Confucius "family is the first unit to introduce normative notions into an individual's psychological fabric, forming the basic dispositions and patterns of reflections and response that will color the rest of the person's moral phenomenology". While Helle's actions may again be seen as a kind of emotional "investment", they are more likely to be the expression of a natural inclination, something that is done not merely for the sake of later benefits, even though these will likely also be obtained. Interestingly, Cheung and Kwan (2009) claim to have shown also "that educational policy and practice can be a means to sustain filial piety in the face of modernization" (179). This might seem to indicate that more institutionalized forms of education and cultivation also contribute to maintaining filial piety and prevent it from "eroding". But Cheung & Kwan use financial support for elderly parents as the prime indicator for filial piety (184), and it is hardly surprising that this correlates with a high level of education. Though they may be right that seeing financial support as an expression of filial piety "is not contentious in China", it is also likely that under modern conditions, financial support rather compensates for a lack of genuine filial piety, or simply reflect the growing affluence of well-educated urban dwellers. Besides, several of the older Chinese interviewed by Zhang et al. (2019) emphasized that although filial piety is related to practical support, it is not about money. There are some slight, but not insignificant indications that even in the Danish cases, the participant's daughters seemed to be more "filial", or at least more frequently involved in the provision of daily care services to parents. Cases where daughters had failed to maintain contact, or not shown appropriate respect, were noted more often. There was also some very positive mention of daughters-in-law, whereas sons-in-law where described more negatively (or at least as non-filial). This is similar to an observation by Shi (2009) , in a suburban community in north-eastern China in terms of the gendered practice of filial piety, suggesting that generally daughters are in charge of the increased emotional care and practical support required by their parents -and expected to be so, which vividly resonates with the Chinese saying "A daughter is like a little quilted vest to warm her parents' heart" (Shi, 2009 ). Here, generativity seems to be a more inclusive notion, as participants obviously also took comfort from knowing that their sons were doing well (or were negatively affected if they were not). The findings clearly confirm the importance of intergenerational relationships, but many of them might also seem to call into question the relevance of the more specific concepts of filial piety and generativity. For they appear to either not match the ideals and experiences of older adults, or to have become unrealistic in light of recent societal developments -or even detrimental to wellbeing (as a potential source of disappointment), and this not just in Denmark, but also in contemporary China. This impression can be corrected, however, by more careful interpretation of both the findings and the concepts. First, Confucius' assumption of filial piety has often been distortedly construed in an authoritarian manner, as a requirement of "unconditional obedience", "filial obligation" or "traditional, conventional behaviour". It has been seen as centering on the idea of "the sacredness of parental authority and the superiority of parents" (Zhang, 2009) , and as entailing a duty respect, obey and give support to parents (Watson, 2004) . Thusly interpreted, in stands in stark contrast to the values of autonomy, independence and self-development, and so appears almost incompatible with especially modern Western thought, but also ideas that have taken root in Chinese society. If, however, it is understood rather as a fundamental attitude and authentic emotional bond, and not as a set of formal obligations, then it seems to be still very strongly valued and wished for, perhaps more than ever, not only in China but also in Denmark. Secondly, the findings do indicate a change in expectations as well as in the actual possibilities for close intergenerational contact, due to more individualized lives and career paths and increased mobility. But they also indicate that close intergenerational relationships can still be forged, maintained and even strengthened (as under the Covid 19-pandemic), with moderate amounts of physical contact or practical support from the children (though some amount of contact and support is clearly needed; and help with practical tasks is strongly appreciated, albeit also as a sign of sincerity of attitude). Again, this is because filial piety is mainly about authentic interest and mutual respect, which can still be demonstrated under current conditions. And it is because generativity is about somehow playing a part in each other's lives and being mindful of each other, though it also needs some practical and material basis, as for example the need to contribute the younger generation can only be satisfied if there is sufficient interaction. Rather than showing that the ideals of filial piety are old-fashioned or impractical, our findings show them to be compatible with contemporary norms and adaptable to typical circumstances of modern urban life. Filial piety and generativity do seem to be potent factors in preventing or alleviating loneliness in older adults, and therefore important, if not crucial to promoting older adults' wellbeing. While this is not surprising it itself, our study has, with use of in-depth analysis of qualitative data and the application of philosophical notions, highlighted different forms, manifestations, conditions and understandings of these phenomena. It has shown them to be surprisingly compatible with contemporary social trends, but also evidenced how modern living conditions, in both China and Denmark, can make it difficult to maintain intergenerational relationships, and how the price in terms of reduced wellbeing, for parents but possibly also for children, can be higher than is usually recognized. There are also indications that the emphasis on filial piety can be something of a double-edged sword, as it can be a source of unrealistic expectations and a burdensome sense of obligations. More significantly, we found a tendency in many older adults to curb their expectations in order to prevent disappointment and avoid burdening their children. While this can be a sensible, perhaps to some extent an indispensable coping strategy, we found evidence that it might take on exaggerated forms, supressing a genuine need rather than positively adapting to the circumstances, and causing a more acquiescent and self-abnegating attitude than is actually necessary. Achieving filial piety may be less problematic or burdensome than it seems. When filial piety is understood as an authentic emotional bond, rather than a formal obligation to meet conventional expectations (an understanding that accords with the traditional Confucian notion, as we interpret it), it seems to be a fairly realistic goal. This does not mean that filial piety is easy to achieve. Fostering an emotional attitude can be more demanding than simply conforming to conventional norms; emotions are fleeting, fickle, complex and difficult to control, though they can be cultivated and supported. But it does not demand of the children that they curb their career or make significant sacrifices in terms of the own wellbeing; and it is a matter of quality rather than quantity (though we also found evidence that some kind of tangible proof of authentic concern, and even observance of duties, is also required; purely empathic concern and long-distance relationships does not suffice). The need for real interaction is also entailed by the notion of generativity, which requires opportunities for older adults to really contribute to the wellbeing of younger generations). And it is filial piety in this particular sense (as an authentic emotional bond) that is most desired -by parents and children alike, though to different degrees -and which seems to have the largest influence on wellbeing and be most effective at alleviating loneliness. The findings from China and Denmark were surprisingly similar. This might seem to indicate both that filial piety and generativity is a fundamental, trans-cultural human disposition (as predicted by both Confucian philosophy and developmental psychology) and that the two societies are converging in terms of experiences, expectations and actual living conditions. It is particularly interesting to note that the Danish older adults expressed hopes and expectations of filial piety and generativity no less strong than the older Chinese, in spite of their different cultural backgrounds. Though the Chinese have been raised in culture that emphasizes collectivism and harmony, and the Danes in a culture that is assumedly more individualist, and where care is seen as being less of a personal or family-related obligation, something like the Confucian ideal of filial piety (xiao 孝) seemed to be acknowledged by both groups. While both also experienced a tension between this ideal and the mundane realities, there were signs that the Danish older adults experienced it as more paradoxical, as a genuine clash of values (and also showed more surprise at experiencing the strength and value of filial piety), whereas the Chinese took it to be due mostly to recent changes in the societal circumstances, to be coped with pragmatically, and less of a value dissonance. While our findings point to the importance of promoting close intergenerational relationships, we cannot conclude that specific forms of eldercare are especially preferable or problematic. As we have noted, institutionalized care has become a practical necessity, and so is probably living alone, at least under current conditions. Moreover, we have found that it is possible to achieve filial piety and reap the benefits in terms of wellbeing and alleviated loneliness even under these circumstances, also in care homes and in situations where parents and children live far apart. Besides, we have not studied cases of intergenerational co-residence and so have not been able to take into account possible negative side-effects of such arrangements. 9 Nevertheless, our findings should serve as a general caution to countries that are currently moving towards highly institutionalized and individualized care. It is noteworthy that there is now also a movement in Denmark and other Western countries to re-establish intergenerational contact and experiment with forms of partial co-residence (Tapper, 2019; Hernandez et al., 2020; Vang, 2020) . A further lesson may be that when it comes to understanding and promoting the factors that support wellbeing most profoundly, one should not shy away from taking seriously notions that have a conservative ring to them or have to do with obligations and values. Confucius' saying "Filial piety (xiao 孝) and fraternal love -they are the root of human-heartedness (ren仁), are they not? (Analects 1.2)" may sound archaic and lofty, but turns out to reflect the needs and expectations of modern-day older Danes and Chinese alike fairly directly. Cultivating sufficiently harmonious family relationships and creating a virtuous circle within the family 10 that reinforces generativity, under modern conditions of life, without impeding other fundamental goals and values -that sounds like a tall order, but seems to be far from impossible. The analects of Confucius. 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A review of problems caused by China's one-child policy and their potential solutions What is the meaning of filial piety for people with dementia and their family caregivers in China under the current social transitions? An interpretative phenomenological analysis Loneliness and cognitive function in older adults: Findings from the Chinese longitudinal healthy longevity survey Acknowledgements Thanks to Anne-Maj Fabricius, Lara Luise Roessler, Freja Bjerck-Amundsen, Anna Hvelplund Pozlep and Tor Petersen, for helping with the data collection for the Danish part of the study.Funding This study was funded by the Velux Foundation (Grant number 18143). The regional Research Ethics Commitee for Southern Denmark decided on February 22, 2018, that the project Elderly wellbeing and alcohol, as based on interviews and observations, did not require the committee's approval. The authors declare that they have no conflict of interest.