Older Adults' and Family Caregivers' Technological Arrangements on Risk of Institutionalization.

Internet-enabled resources could facilitate older adults' ability to live in the community longer, but studies have often overlooked how family caregivers utilize the internet to assist older care recipients. We examined whether different family-level arrangements of internet use may affect the risk of institutionalization among older adults. Using the National Health and Aging Trends Study (2015-2020) and National Study on Caregiving (2015), we estimated multinominal logistic regression and inverse-probability weighted Cox proportional hazard models to investigate the determinants of technological arrangements in 2015 (i.e., no internet use, only caregiver use, only care recipient use, both caregiver and care recipient internet use) and how they may affect the risk of moving to an assisted living or nursing facility between 2015 and 2020. The most prevalent technological arrangement in 2015 was the one where neither the care recipient nor their caregiver reported using the internet. Relatively disadvantaged older care recipients (e.g., people of color, fewer years of education, less income, worse cognitive functioning) and caregivers (e.g., older, fewer years of education) were more likely to be in a non-internet use arrangement. Compared to older adults in other categories, older adults who were internet users and had a family caregiver who also used the internet in their caregiving tasks had a much lower risk of relocation during the study period. Findings suggest that digital interventions aimed at serving the older adult population should assess the gap in access and utilization at a family level and consider the role of older adults' social partners.