Differences in utilities for long-term care settings among older adults with and without living children

Sims TL, Garber AM, Goldstein MK. Differences in utilities for long-term care settings among older adults with and without living children. Poster session presented at: Gerontological Society of America Annual Scientific Meeting; 2005 Nov 18; Orlando, FL.

Frequent help from children with basic personal care reduces the likelihood of nursing home use by disabled older adults (LoSasso and Johnson); however, it is not known how having children, a potential resource for long-term care, may affect older adults' preferences for future residence in a nursing home versus their own home. 316 medical outpatients (Mean age = 75, 65% female, 35% non-white) rated hypothetical health states of dependency in bathing, dressing, and transferring while living in a nursing home or their own home. Ratings were transformed to utilities using a conventional 0(death) to 1(perfect health) scale.Independent samples t-tests revealed lower utilities for the nursing home site of care for those with children, mean = .514 (sd = .35) than those without, mean = .561 (sd = .369), although the difference was not significant. Those with children reported slightly higher utilities for own home as site of care, mean = .610 (sd = .337) than those without, mean = .577 (sd = .369), not significant. Difference scores between nursing home and own home demonstrated a mean difference of .096 (sd = .250) for those with children, significantly greater than a mean difference of .016 (sd = .238) for those without, t(314) = 2.014, p < .05.These findings suggest that the utility loss for nursing home residency is greater for older people with children than for those who are childless. Those without children appear not to have a strong preference for site of long-term care. Possibly, older adults with children would like their children to be involved in their future care, and see this as more likely if they are in their own home.