Spousal Loss, Children, and the Risk of Nursing Home Admission
Spousal Loss, Children, and the Risk of Nursing Home Admission
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DOI：
10.1093/geronb/gbq020
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发表时间：
2010-05-01
影响因子：
6.2
通讯作者：
Noel-Miller, Claire
中科院分区：
文献类型：
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作者：
Noel-Miller, Claire
本研究从生命历程的观点出发，以健康与退休研究的纵向数据为基础，对1998年居住在社区的2,116对夫妇进行了研究，探讨了丧偶和成年子女的可获得性对老年夫妇进入养老院风险的影响。在8年的随访中，我们估计了丈夫和妻子第一次入住疗养院的时间的比例风险模型，总共有438名（20.7%）丈夫和382名（18.1%）妻子被机构化，362名（17.1%）丈夫和701名（33.1%）妻子失去了他们的配偶。考虑到测量的协变量，配偶死亡后男性进入养老院的风险增加了一倍，但女性没有变化。研究结果表明，成年子女降低了妻子的养老院入院的风险，无论丈夫的生命状态，但缓冲丈夫的风险后，他们的妻子去世。我们发现了父母-子女性别一致性的暗示性证据，表明丧偶父母的机构化风险对子女的缓冲作用。我们的发现与配偶抚养和丈夫和妻子对伴侣和子女照顾的相对依赖性的性别差异一致。本研究为已婚老年人的机构化与家庭结构的关系提供了新的证据。
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.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.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.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.