Measuring spatial availability of children for older adults with disability

Background: Having an adult child living with or nearby may prevent parents with disability from moving to nursing homes and reduce the use of paid care services. Despite the profound implications for care resources and utilization among older adults, there is no measure summarizing the spatial availability of all adult children for an older adult. Our study aims to develop a holistic measure of adult children's spatial availability to assess potential family care resources for older adults with disability.Methods: Data were obtained from the population-based, longitudinal study in the U.S., the Health and Retirement Study (HRS). We selected a nationally representative sample of older adults 55+ years with disability. Using multivariable two-part regression models, we developed a care-weighted child spatial availability for caregiving (CSAC) index, which summarizes the spatial dispersion of all adult children accounting for potential caregiving associated with distance. We also constructed a reference index of child spatial proximity (CSP) focusing only on spatial distance by employing Gaussian kernel weighting functions.Results: CSAC index highlights the great importance of having an adult child in the same household (vs. nearby or far) for receiving care among older adults with disability, compared to the CSP index, showing relatively a gradual decline over the spatial distance. Both indices vary substantially by older adults' sociodemographic attributes.Conclusions: The holistic indices of adult child spatial availability will contribute to assessing care resources for older adults, albeit future development is needed to extend the utility of the indices tailored for specific care needs.