Spiritual affection and support: Unique aging model of older adult Chinese who lost their only child

Shidu parents are a group unique to China due to the one-child policy initiated in the 1980s. As of 2020, there were approximately 4.695 million shidu parents, about 5.7% of the aging population, with some impoverished regions exceeding 10%. Traditionally, adult children are central to family-based old-age support, but shidu parents lack this key node in their social support system, leading to material and especially spiritual care gaps. The study focuses on the psychological and social consequences of losing an only child and investigates a spiritually drawn-together aging model that uses peer networks to replace the missing family subsystem for emotional belonging and self-worth. The research aims to elucidate how online spiritual solidarity groups support shidu parents’ quality of life and mental health and to propose practical policy suggestions.

Related work highlights: (1) Shidu parents face a severe dilemma of spiritual comfort because institutional care is often inaccessible or undesirable; they may avoid nursing homes due to emotional triggers and stigma, while policies and admissions often pose barriers. The satisfaction of spiritual needs is more important than material needs for this group, yet social services remain insufficient. (2) Spiritually getting old together has emerged as a preferred approach due to loss of traditional pension foundations and high psychological stress; peer support is increasingly essential. Online platforms (WeChat, QQ) enable companionship, sharing, and informal support networks. (3) The drawn-together-to-become-old model is defined as similar older adults voluntarily uniting to meet spiritual needs and reduce loneliness via mutual communication. Scholars argue for adding a spiritual dimension; while debate exists over the magnitude of its effect, many studies suggest it can substantially meet deep psychological needs and complement existing support systems.

Design: Qualitative study with multi-case interviews supplemented by questionnaires, focusing on an online WeChat community implementing a spiritually drawn-together aging model. Rationale: Quantitative methods alone cannot easily control complex behavioral and mutual support variables; qualitative methods better capture mechanisms and experiences. Setting and sample: The 'Lone Ranger' WeChat group (established ~4 years; 473 members) was selected due to relative maturity. Fifty-one newly joined older adults (in group less than one week) completed questionnaires to capture early changes; 12 representative members participated in semi-structured, in-depth interviews using stratified sampling by years since loss and heterogeneity in age (57–69), marital status, social/household registration status, income, and health. Ethical procedures: Participation was voluntary, anonymized; confidentiality, data retention, and consent procedures were communicated; no clinical interventions were involved. Measures and procedure: A self-rating depression scale tailored to older adults (Geriatric Depression Scale, GDS) was administered twice, three months apart, to the 51 newcomers. Interviews explored motivations, channels of enrollment, group activities, perceived support, and outcomes. Content analysis included lexical indicators (e.g., frequency of emotionally oriented words). Group activities included daily/weekly check-ins, policy information compilations shared weekly, and open sharing of difficulties and successes. Baseline characteristics of the 51 respondents included age distribution (50–55: n=16; 56–60: n=13; >60: n=22), sex (26 female, 25 male), and income sources (about 71% pension, 31% alms, others varied). Interviewee health conditions varied (e.g., hypertension, bronchitis, hyperglycemia, disability).

• Depression outcomes (n=51 newcomers): From baseline to 3 months, counts changed as follows: no depression 10→23; mild 26→18; moderate 12→7; severe 3→3. Relative reductions: moderate −41.67%; mild −30.76%. Baseline distribution was about 20% non-depressed, 51% mild, 23% moderate, 6% severe.
• Linguistic sentiment shift: 21.57% fewer negative words in second conversations versus first after engagement in group activities.
• Single-item scale changes: Positively graded items (higher score = more negative emotion) decreased substantially, e.g., item 1 (I feel unhappy and depressed) −37.18%; item 4 (I sleep poorly at night) −44.67%. Negatively graded items (higher score = more positive emotion) increased: item 17 (I feel helpful and needed) +210%; item 5 (I eat as much as usual) +127%.
• Mechanisms identified: (1) Peer support compensates for missing child support, providing instrumental help (guidance, assistance, problem-solving, tangible support) and expressive support (emotional, esteem, recognition). (2) Emotional support from peers partially replaces the lost family subsystem’s function, fostering companionship, reducing stigma concerns, and building belonging. (3) Information sharing mitigates information deficits, especially among less educated or rural elders; group members curate and disseminate relevant policies and resources, enabling problem resolution (e.g., a member’s granddaughter’s medical billing and school resumption). (4) Group interaction fosters belonging and self-actualization (per Maslow), with members reporting accomplishment and purpose through contributing to others.

The findings suggest that an online spiritually drawn-together aging model can ameliorate psychological distress and address practical challenges for shidu parents by rebuilding informal support systems. Peer networks operate as a substitute node in the social support structure, providing instrumental and emotional resources analogous to those once provided by children. The group compensates for the absence of family subsystem functions, thereby improving quality of life. Information sharing reduces structural disadvantages in policy access and service navigation. By fulfilling belongingness and esteem needs, members progress toward self-actualization, helping them transcend grief and reintegrate socially. These mechanisms offer a process model: peer support, emotional replacement, information sharing, and group interaction jointly influence behaviors and well-being. The model has policy relevance for strengthening community-based and digitally mediated support infrastructures for vulnerable older adults.

Spiritual solidarity groups transform shidu parents from isolated individuals into socially connected partners, building robust peer-based support networks that alleviate anxiety and depression and promote social integration. Functionally, the group serves as a surrogate family, providing empathetic companionship and practical assistance tailored to shared experiences. This model can inform government policy and social initiatives to safeguard the rights and improve the material and spiritual quality of life of shidu parents. The approach also holds international relevance for societies facing similar bereavement-related aging challenges. Future research should expand samples across multiple groups and regions, include control groups of non-participants, and work toward a standardized group eldercare model.

• Sample scope: Only 63 shidu parents from a single WeChat group (51 surveyed newcomers and 12 interviewees), limiting generalizability.
• Study design: No control group for comparative analysis; participants were already group joiners, introducing selection bias.
• External validity: Findings pertain to a relatively mature online group; effects may differ in nascent or offline contexts.
• Measurement constraints: Self-report measures and qualitative accounts may be subject to recall and social desirability biases.