Cover: Family Structure and the Risk of Nursing Home Admission

Family Structure and the Risk of Nursing Home Admission

Published 1995

by Vicki A. Freedman

Purchase Print Copy

Add to Cart Paperback8 pages Free

Given the high costs associated with institutionalization, understanding factors related to nursing home admissions is of considerable interest. The family is particularly relevant to a discussion of nursing home admission, given its critical role in providing care to older disabled persons. Using data from the New Haven EPESE, the author examines the relationship between family structure and the risk of first nursing home admission. Family structure is defined more broadly than in most previous studies and includes not only the spouse, but also sons, daughters, and siblings. Because of the relatively lengthy follow-up period of the EPESE, the author is able to depart from previous methodological conventions, adopting a continuous time survival model with age at admission as the outcome and time-varying measures of family structure and health. Results show that married older persons have about half the risk of nursing home admission of unmarried persons, and that having at least one daughter or sibling reduces and older person's chances of admission by about one-fourth.

Originally published in: The Journal of Gerontology Social Sciences, v. 51B, no. 2, pp. S61-S69.

This report is part of the RAND reprint series. The Reprint was a product of RAND from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.