Effect of Childlessness on Nursing Home and Home Health Care Use

Abstract

This study examines the likelihood of nursing home and home health care use for childless older Americans. Four research questions are addressed: (1) Are the childless elderly at a greater risk of nursing home and home health care use? (2) Is it childlessness per se or not having children with particular characteristics that affects the likelihood of using these formal long-term care services? (3) Does having additional children beyond the first one have a significant effect on the use of these services? (4) Are the effects of childlessness different on the likelihood of nursing home and home health care use? Longitudinal data from the first (1993) and second (1995) waves of the Asset and Health Dynamics Among the Oldest Old Survey (AHEAD) and multinomial logistic regression models are used for the analyses. Separate models are developed for women and men, each controlling for a variety of demographic, socioeconomic, and health-related characteristics of sample persons. Findings indicate childlessness as an important risk factor, especially for older women's use of nursing home services. Implications of findings for planning for long-term care needs of the baby boom generation are discussed.

The Magnitude, Share and Determinants of Private Costs Incurred by Clients (and Their Caregivers) of In-home Publicly Financed Care

“…Females had lower private expenditures because they spent less time caring for themselves and received less caregiver assistance than male clients. This finding is consistent with previous studies that found females to be less likely to receive care and more likely to provide care to others (Aykan 2003;Katz et al 2000;Walter-Ginzburg et al 2001). We conjecture that women may take on caregiver roles more often than men, as suggested by our survey of caregivers (62% were female), because they perceive activities related to caregiving to be their responsibility within the home.…”

“…Also of note, divorced or widowed clients may not have had a statistically different private share because they may have received more support than unmarried clients but less support than married clients; thus, they may have received an intermediate amount of care. Support may have been provided by children, as previous research has found children to be the most important source of care for elderly women (Aykan 2003).…”

The influence of infertility and in vitro fertilization treatment on postpartum and long-term mental health in women

“…These results are contrary to those of previous studies that have shown an increased risk of institutionalized housing in the childless American, Australian and Welsh elderly (179,183,184). These contrasts can be explained by showed that those who were parents were more likely than those who were childless to receive informal support while the childless compensated by receiving more formal support from health care services.…”

“…Larsson et al (181) concluded that while formal services do not appear to fully compensate for the support deficits among the childless, having children is not a guarantee of receiving support since the children of the oldest old are likely to be approaching old age themselves. Some studies from western countries have shown that older childless individuals are more likely than parents to live in institutional housing (179,183,184).…”

Childlessness and Parenthood in Two Centuries

“…Even though norms of reciprocity may give some assistance from individuals whom they helped in the past, their "care accounts" run empty sooner (Romøren & Hagestad, 1988). Consequently, as several studies have shown, those without children are more likely to depend on formal services at the end of life (Aykan, 2003;Chapman, 1989;Choi, 1994;Freedman, 1996;Larsson & Silverstein, 2004) and to utilize such care for a longer duration than is the case for individuals with children (Romøren & Hagestad, 1988). In countries with few formal care arrangements available, frail childless elderly are particularly vulnerable.…”