Center for the Demography of Health and Aging (CDHA), University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI 53706, USA.
J Gerontol B Psychol Sci Soc Sci. 2010 May;65B(3):370-80. doi: 10.1093/geronb/gbq020. Epub 2010 Apr 6.
UNLABELLED: OBJECTIVES. 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. METHODS: 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. RESULTS: 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. Discussion. 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.
目的:本研究从生命历程的角度出发,探讨配偶去世和成年子女的可用性对老年夫妇入住养老院风险的影响。
方法:本研究基于“健康与退休研究”的纵向数据,研究了 1998 年居住在社区的 2116 对夫妇。我们在 8 年的随访期间,估计了丈夫和妻子首次入住养老院的比例风险模型。
结果:共有 438 名(20.7%)丈夫和 382 名(18.1%)妻子被安置在养老院,362 名(17.1%)丈夫和 701 名(33.1%)妻子丧偶。在考虑到测量的协变量后,配偶去世后男性入住养老院的风险增加了一倍,但女性的风险不变。结果表明,成年子女降低了妻子入住养老院的风险,无论丈夫的健康状况如何,但只有在妻子去世后,才会缓冲丈夫的风险。我们发现了一些暗示性的证据,表明在子女对丧偶父母的机构化风险的缓冲作用方面存在亲子性别一致性。
讨论:我们的研究结果与配偶照料和丈夫与妻子对伴侣和子女照料的相对依赖方面的性别差异一致。本研究为已婚老年人的机构化与家庭结构之间的关系提供了新的证据。
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