title: Spousal loss, children, and the risk of nursing home admission.
abstract: 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.
authors.affiliation: Center for the Demography of Health and Aging (CDHA), University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI 53706, USA. cnoel@ssc.wisc.edu
authors.forename: Claire
authors.initials: C
authors.lastname: Noël-Miller
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D032721:Adult Children; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001601:Bereavement; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data / Q000600:supply & distribution; D005191:Family Characteristics; D005260:Female; D005783:Gender Identity; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000523:psychology; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D010287:Parent-Child Relations; D010343:Patient Admission / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012944:Social Support; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data; D014600:Utilization Review