Adult children's gender, number and proximity and older parents’ moves to institutions: evidence from Sweden

Balancing Formal and Informal Caregiving Resources for Older Adults: The Role of Spatial Proximity of Family

OBJECTIVES

To explore how informal and formal home care was balanced for older adults under the weakening informal caregiving systems due to sociodemographic changes in South Korea, this study examined the relationship between the two types of care and the effects of proximity to family caregivers on them.

METHODS

We analyzed adults aged 65 years and older from the 7th wave of the Korean Longitudinal Study of Aging (n = 722) with limitations in activities of daily living or instrumental activities of daily living or dementia. Multinomial logistic regression was adopted to analyze the impact of family structure on the choice of informal caregivers. Two-stage least squares, Heckman, and IV-Heckman models were applied to address endogeneity and sample selection biases.

RESULTS

The results demonstrated that spouses and children close to older parents appeared to be primary caregivers. According to the IV-Heckman model, informal care substitutes for formal home care (b = -0.416, p < .01), and both being married (b = 0.715, p < .01) and proximity to children within 1 hr (b = 0.888, p < .01) appeared to facilitate formal home care use.

DISCUSSION

This study reveals that informal and formal home care are inextricably linked. Spouses and adult children close to parents play a pivotal role in directly providing informal care and indirectly facilitating formal home care. Balancing informal/formal home care should be considered in medium- and long-term plans to improve older adults' well-being and reduce formal care's financial burden.

Children-related factors associated with life satisfaction of urban older adults living alone in China

Introduction

The aim of this study is to investigate the association between the number of children, their gender structure, and the gender of children by birth order with the life satisfaction of urban older adults living alone (UOALA) in five Chinese cities. Traditional reproductive views suggest that having more children, especially sons, is associated with higher life satisfaction for older adults.

Methods

This study utilized a cross-sectional design and included a sample of 2,801 UOALA from five Chinese cities. The life satisfaction of participants was measured using standardized questionnaires. To analyze the data, both OLS and OLogit methods were employed.

Results

Empirical research shows that the number of children has a positive association with life satisfaction of UOALA, which is greater in male older adults than in female ones. The increase in the number of daughters is significantly associated with higher life satisfaction. In terms of gender structure, UOALA with multiple children, including both sons and daughters, tend to have a higher level of life satisfaction, which partly validates the cohort reproductive preference. In terms of gender of children by birth order, UOALA whose first child is a daughter have higher life satisfaction, which is more pronounced among male UOALA, while the association of gender of children by birth order on female UOALA is relatively weak.

Discussion

This study contributes to the understanding of the factors associated with the life satisfaction of UOALA in China. The findings suggest that having more children, particularly daughters, and a balanced gender structure of children is associated with higher levels of life satisfaction. The study suggests the need for targeted social support for UOALA with varying family structures.

Measuring spatial availability of children for older adults with disability

BACKGROUND

Having an adult child living with or nearby may prevent parents with disability from moving to nursing homes and reduce the use of paid care services. Despite the profound implications for care resources and utilization among older adults, there is no measure summarizing the spatial availability of all adult children for an older adult. Our study aims to develop a holistic measure of adult children's spatial availability to assess potential family care resources for older adults with disability.

METHODS

Data were obtained from the population-based, longitudinal study in the U.S., the Health and Retirement Study (HRS). We selected a nationally representative sample of older adults 55+ years with disability. Using multivariable two-part regression models, we developed a care-weighted child spatial availability for caregiving (CSAC) index, which summarizes the spatial dispersion of all adult children accounting for potential caregiving associated with distance. We also constructed a reference index of child spatial proximity (CSP) focusing only on spatial distance by employing Gaussian kernel weighting functions.

RESULTS

CSAC index highlights the great importance of having an adult child in the same household (vs. nearby or far) for receiving care among older adults with disability, compared to the CSP index, showing relatively a gradual decline over the spatial distance. Both indices vary substantially by older adults' sociodemographic attributes.

CONCLUSIONS

The holistic indices of adult child spatial availability will contribute to assessing care resources for older adults, albeit future development is needed to extend the utility of the indices tailored for specific care needs.

Do characteristics of family members influence older persons' transition to long-term healthcare services?

BACKGROUND

Future demographic and economic changes warrant a better understanding of older persons' need for health-related long-term care services (LTC). LTC uptake among older people is likely to be influenced by the presence or absence of family members, but there is scarce research on the role played by partners with different caregiving potential. There is even less research on the contributions of adult children and their caregiving potential. The current study examines the extent to which transitions into LTC in older men and women differ according to the presence and caregiving potential of partners and children.

METHODS

Linked registry data for Norway on older persons (aged 65+), their partners, and their adult children are used to examine how characteristics of these family members influence transitions into LTC from 2010 to 2016, using logistic discrete-time hazard regression models. We observed around 215,000 transitions to LTC, corresponding to around 26.3% of individuals and 5.4% of the total person-years (4.0 million). Caregiving potential is measured in terms of employment, income, health and educational attainment for partners and education and geographical proximity for children.

RESULTS

Personal, partner and child(ren)'s resources are all associated with older persons' LTC uptake. Unpartnered and/or childless older people are more likely to use LTC than those with partners and/or child(ren). Older persons with resourceful partners and children are the least likely to transition into LTC. The geographical proximity of adult children appears to have only a minor influence on LTC use among older people.

CONCLUSIONS

Population ageing and strained public resources will likely challenge the future provision of formal old-age care. The role of family networks in the future provision of formal old-age care is expected to become progressively important in the years to come. Inequalities in the health, care and welfare of older persons with and without resourceful family members are likely to increase.

Do older parents' assistance needs deter parent-child geographic divergence in Norway?

The role of intergenerational geographic proximity in individuals' migration decisions has been well-established. The circumstances under which parents and their adult children move away from or remain close to each other are, however, less clear. Drawing on Norwegian register data for 2014-2016 and three-level logistic regression models, we examine whether formal care needs of older parents (aged ≥65) deter parent-child geographic divergence and whether variation in the likelihood of divergence is associated with municipal-level characteristics. After accounting for location-specific capital and parents' and children's sociodemographic characteristics, parents and children were less likely to diverge after the onset of parental care needs. Utilising in-home nursing decreased the likelihood of divergence for mothers while utilising institutionalised care decreased the likelihood of divergence for fathers. The use of in-home nursing care among single mothers further reduced the likelihood of divergence. Parents and adult children living in central areas were the least likely to diverge geographically. The likelihood of intergenerational divergence was lower for fathers and children living in municipalities with high healthcare spending.