Table 3 Themes, example of quotations, and settings of primary studies that constitute themes

Family orientation

Expectation for offspring

“… I do not need their money. All I needed is their affection and emotional support. Everyone around talks about this. It is so shameful that my own children do not visit me or care for me.” (65-year-old female, rural, literate) [28]

All settings (nursing homes, residential care homes, shelter homes, community) [28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48]

Experiencing disrespect from family members

Our 79-year-old female participant shared, “I am also forgetful, sometimes she gets irritated, and she tells me, ‘You said that already, you keep repeating yourself’” (translated from Filipino). This quote expresses experiences of disrespect when some social network members do not regard the elderly positively when symptoms of aging, such as forgetfulness, are exhibited [32]

Shelter homes, community [32, 33, 43]

Appreciation on family reputation

Influenced by a traditional mindset, some seniors feel that it would harm their children’s dignity and their family's reputation if they were to reside in a nursing home for supportive care: “If I went to a nursing home in the future, then people would think that my children were impious, and my children might feel their reputation was impaired.” [31]

Community [28, 31, 33, 37, 41]

Gathering and celebrating festive days with family and friends

However, most (n = 7) of them mention that the visits are often during major festivals, as a participant explained, “Yes! I have eight or nine great-grandchildren. But I do not see them much. Well, yes, they do come to see me. During the big festival, these children come to visit me to have a festival gathering dinner. Some of them would drive all the way back here to visit.” [29]

Community [29, 38]

Food as a symbol of family cares

The extra physiological support for food, clothing and other living necessities from family members who were present was a symbol of “family cares” that they live better lives at the homes: “My daughter bought me some snacks as dinner was served at 5 pm and I ate little. I was hungry by midnight.” [30]

Nursing homes, residential care homes, community [30, 34, 37, 45, 49]

Having faith in religion

Expectation for spiritual support

Stronger faith was much more important, especially if a life-threatening situation comes in their way: “This is the time that we should look up to God and pray. We can surpass this.” [27]

Nursing homes, shelter homes, community [27, 28, 32,33,34,35, 37,38,39, 41, 43, 45, 46, 49]

Accepting situations

“Even though health control, medication, and diet are so important, but more important is surrender to God, accepting destiny happened and sincere” [39]

Community [34, 39, 46]

Religious social support

“Religious affiliation and practice was frequently reported in our sample, with religious affiliations ranging from Christianity, Buddhism, Taoism, Muslim, and Hinduism. Despite religious affiliation, older adults identified the positive impact engaging in religious activities had on their social health. They highlighted how being part of a religious group allowed them to be around people who shared similar beliefs, and they felt a sense of belonging and purpose” [37]

Residential care homes, community [35,36,37, 41, 42, 46, 47]

The importance of elderly providing support

“Helping and sharing significant concern for others allowed some older adults to feel better about themselves. It also gave many the motivation to look after their own health, especially if they were providing care to someone close to them, e.g., family member, partner, or close friend” [37]

Community [28, 32, 33, 35, 37, 39, 44]

Taboos

“I have told my daughter (about my death) and wanted to say a nice goodbye. She does not want to listen to me. She becomes angry when I mention it. I want to talk, but she does not want to listen” (Mr. Hsu). However, discussing death is somewhat of a taboo in Chinese society [45]

Shelter homes, nursing homes, community [28, 37, 41, 43, 45]

Elderly self-reliance

“The young‐old reported that there was a lack of formal instrumental support in the community they live. They mainly do the housekeeping work by themselves, as most of them are independent at this stage” [44]

Nursing homes, residential care homes, community [29, 31, 34, 36, 42, 44, 45, 47]

Elderly fear of being a burden

“My legs hurts when I walk or try to climb stairs. So far, I can take care of myself. I hope I would go (die) before I get bedridden” [28]

Shelter homes, residential care homes, community [28, 30, 35, 42, 43, 46, 47]

Differences on perceptions and experiences regarding social support

Younger-old vs. Older-old

“The young‐old reported that the formal emotional support increased compared to their parents’ generation as the community increasingly organizes social activities. The informal emotional support from their children and neighbors, however, decreased compared to their parents' generation and the older‐old living in the same community. The neighbors were all Beijing local residents in the past. We understood each other and cared about each other. The neighbors were like families. If my neighbor’s relatives came and there was no place to stay, they just came to stay in my home. Now is different. People become selfish, especially these migrants. The society has changed a lot” [44]

Residential care homes, community [36, 44]

Male vs. female

“At first, men expressed social support, which was more related to formal, including social role and local meeting. In addition to this, their expression of life events which related to life satisfaction in the past and future was their business and social role. Compared to males, females discoursed their social support and life satisfaction as being related to friends and family. Additionally, in terms of life satisfaction in the past, current, and future, females’ life events related more to family events and situation” [40]

Community [28, 35, 40, 41]

Having family vs. having no family

However, this is contrary to groups of older adults without families. Looking for alternative sources of food and shelter is much more important than praying. Their life is focused on action and not solely prayer: “I need to look for alternative resources. If I will rely on asking for a miracle, I might be dead.” [27]

Community [27]