title: Living arrangements, relationship to people in the household and admission to care homes for older people.
abstract: OBJECTIVE
  to assess the separate contributions of marital status, living arrangements and the presence of children to subsequent admission to a care home.
  
  
  METHODS
  a longitudinal study derived from the health card registration system and linked to the 2001 Census, comprising 28% of the Northern Ireland population was analysed using Cox regression to assess the likelihood of admission for 51,619 older people in the 6 years following the census. Cohort members' age, sex, marital and health status and relationship to other household members were analysed.
  
  
  RESULTS
  there were 2,138 care home admissions; a rate of 7.4 admissions per thousand person years. Those living alone had the highest likelihood of admission [hazard ratio (HR) compared with living with partner 1.66 (95% CI 1.48, 1.87)] but there was little difference between the never-married and the previously married. Living with children offered similar protection as living with a partner (HR 0.97; 95% CI 0.81, 1.16). The presence of children reduced admissions especially for married couples (HR 0.67 95% CI 0.54, 0.83; models adjusting for age, gender and health). Women were more likely to be admitted, though there were no gender differences for people living alone or those co-habiting with siblings.
  
  
  CONCLUSIONS
  presence of potential caregivers within the home, rather than those living elsewhere, is a major factor determining admission to care home. Further research should concentrate on the health and needs of these co-residents.
authors.affiliation: Institute of Child Care Research, Queens University Belfast, Belfast, UK. mark.mccann@qub.ac.uk
authors.forename: Mark
authors.initials: M
authors.lastname: McCann
authors.forename: Michael
authors.initials: M
authors.lastname: Donnelly
authors.forename: Dermot
authors.initials: D
authors.lastname: O'Reilly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D005260:Female; D006304:Health Status; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D017533:Marital Status / Q000706:statistics & numerical data*; D009660:Northern Ireland; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment; D012944:Social Support; D012959:Socioeconomic Factors