title: Spouse and Child Availability for Newly Disabled Older Adults: Socioeconomic Differences and Potential Role of Residential Proximity.
abstract: OBJECTIVE
  To examine the potential role of child and spousal availability in facilitating community-based care for disabled older adults.
  
  
  METHODS
  We used the Health and Retirement Study, a nationally representative longitudinal study of older adults. The analysis sample included older adults who were nondisabled at baseline, but who then developed at least one activity of daily living (ADL) limitation over the subsequent 2-year period (N = 2,094). Using multivariate, multinomial logistic regression, we examined the association of child and spouse availability prior to disablement of the older adults with ADL care receipt status after the onset of disablement, after adjusting for other sociodemographic and clinical characteristics.
  
  
  RESULTS
  Lower socioeconomic status (SES) was associated with less availability of a spouse but greater availability of children at baseline. Compared with older adults who had no children nearby (i.e., all children lived further than 30 miles), older adults who had at least one child living with or near them prior to the onset of the ADL limitation were less likely to go to a nursing home (adjusted odds ratio [AOR]: 0.26 for coresident; AOR: 0.44 for 1- 30 miles) and less likely to depend on formal care (AOR: 0.39 for coresident; AOR: 0.51 for 1-30 miles) after the onset of new ADL limitation/s.
  
  
  CONCLUSIONS
  Understanding SES variations in the informal care resources, and potential role of child geographic availability, may inform the development of cost-effective community-based care programs and policies.
authors.affiliation: Department of Internal Medicine, School of Medicine, hwajungc@umich.edu.
authors.forename: HwaJung
authors.initials: H
authors.lastname: Choi
authors.forename: Robert F
authors.initials: RF
authors.lastname: Schoeni
authors.affiliation: Department of Internal Medicine, School of Medicine, Institute for Social Research.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Langa
authors.affiliation: Department of Internal Medicine, School of Medicine, Ann Arbor Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan. Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Heisler
mesh_terms: D000203:Activities of Daily Living; D032721:Adult Children / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006701:Home Nursing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012923:Social Class; D018454:Spouses / Q000706:statistics & numerical data*
keywords: Disability; Geographic proximity; Informal care; Socioeconomic status.