Stability and changes in living arrangements: relationship to nursing home admission and timing of placement.
OBJECTIVE
To examine whether stability of living arrangements and changes in household composition-both types and frequency-influence nursing home placement or timing to entry among older people.


METHODS
Data from the first 5 waves of the Assets and Health Dynamics of the Elderly (1993-2002) on 8,093 persons aged 70 years or older at baseline are used in probit and hazard models to predict nursing home entry and time to entry.


RESULTS
Stable living arrangements carry different risks of institutionalization. Those living continuously alone or with others were at highest risk; at lowest risk were those living continuously with a spouse or the same child (lowest overall). Changes in household composition were protective against nursing home entry and slowed time to entry; types of change were not influential when number of changes was taken into account.


CONCLUSIONS
Results suggest that stability of living arrangements in and of itself is not protective against institutionalization. Having options that allow one to change living arrangements over time in response to changing needs for assistance is of importance if the goal is to avoid institutional care or extend community residence prior to entry.
Kasper
Judith D
JD
Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Pezzin
Liliana E
LE
Rice
J Bradford
JB
D000368:Aged; D000369:Aged, 80 and over; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012307:Risk Factors; D012847:Single Person / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States