Researchers at the University of Michigan have found major differences in potential family caregiver availability — and likelihood of moving to a nursing home — based on the gender, race, ethnicity, education level and family structure of older adults with dementia.
The study draws from comprehensive interviews conducted between 2002 and 2014 with a national sample of nearly 5,000 people with dementia. The data come from the Health and Retirement Study, which is based at the university’s Institute for Social Research.
Overall, they found that people with dementia who are women, Black, low-income or have lower levels of education are all less likely than their counterparts to have available spouse caregivers, but more likely to have adult children available to provide care. The study also showed that the immediate availability of adult children is directly associated with the chances that a person with dementia will continue to live at home or move to a nursing home.
In all, 62% of people with dementia didn’t have a spouse or partner living with them. Another 13% lived with a spouse or partner who needed help with daily living activities themselves. Only 24% lived with a spouse who had no limitations on their abilities. In addition, one-quarter of older adults with dementia lived with an adult child, and an additional 42% had at least one adult child living within 10 miles. But 23% had no adult children living with them or close by.
Based on follow-up interviews done two years after the first, data showed that an older adult with dementia was half as likely to move into a nursing home if they lived with an adult child. Nearly one-third of those with no adult children were receiving nursing home care by the two-year followup, as were one-quarter of those without an adult child living within 10 miles of them. By comparison, 11% of those who had an adult child living with them at the first interview point had moved to a nursing home by the end of two years.
“Given the prevalence of dementia and the high cost of in-home and long-term care, finding ways to support family caregivers and better understand the challenges they face is timely and important,” said Cathleen Connell, Ph.D., senior author of the study and professor at the University of Michigan School of Public Health Department of Health Behavior and Health Education.
Full findings were published in the September issue of Health Affairs.