Spousal loss, children, and the risk of nursing home admission.

TitleSpousal loss, children, and the risk of nursing home admission.
Publication TypeJournal Article
Year of Publication2010
AuthorsNoël-Miller, C
JournalJ Gerontol B Psychol Sci Soc Sci
Date Published2010 May
ISSN Number1758-5368
KeywordsActivities of Daily Living, Adult children, Aged, Aged, 80 and over, Aging, Bereavement, Caregivers, Family Characteristics, Female, Gender Identity, Homes for the Aged, Humans, Long-term Care, Male, Nursing homes, Parent-Child Relations, Patient Admission, Proportional Hazards Models, Social Support, Spouses, Utilization Review

UNLABELLED: OBJECTIVES. Informed by a life course perspective, this study investigates the effects of spousal loss and availability of adult children on elderly husbands' and wives' risk of nursing home entry.

METHODS: Based on longitudinal data from the Health and Retirement Study, we studied 2,116 couples who were community residents in 1998. We estimate proportional hazards models for husbands' and wives' duration to first nursing home admission during 8 years of follow-up.

RESULTS: Overall, 438 (20.7%) husbands and 382 (18.1%) wives were institutionalized, and 362 (17.1%) husbands and 701 (33.1%) wives lost their spouse. Accounting for measured covariates, the risk of nursing home entry doubled for men following spousal death, but was unchanged for women. Results indicate that adult children reduced wives' risk of nursing home admission regardless of husbands' vital status, but buffered husbands' risk only after the death of their wives. We uncover suggestive evidence of parent-child gender concordance in children's buffering effect of widowed parents' risk of institutionalization. Discussion. Our findings are consistent with gender variations in spousal caregiving and in husbands' and wives' relative reliance on care from a partner and children. This study provides new evidence on the relationship between institutionalization and family structure among married elderly persons.

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Endnote Keywords

Activities of Daily Living psychology/Adult Children/Aged, 80 and over/Aging psychology/Bereavement/Caregivers psychology supply/distribution utilization/Family Characteristics/Female/Gender Identity/Homes for the Aged utilization/Humans/Long-Term Care psychology/Nursing Homes utilization/Parent-Child Relations/Patient Admission statistics/numerical data/Proportional Hazards Models/Social Support/Spouses psychology statistics/numerical data/Utilization Review

Endnote ID


Alternate JournalJ Gerontol B Psychol Sci Soc Sci
Citation Key7463
PubMed ID20371551
PubMed Central IDPMC2853605