Long-Term Care of the Disabled Elderly: Spouses, Children, and Stepchildren

Liliana E. Pezzin, Medical College of Wisconsin
Robert A. Pollak, Washington University in St. Louis
Barbara Schone, Agency for Healthcare Research and Quality (AHRQ), HHS

How do adult children affect the care that their elderly parents provide to each other? We develop two models in which children act as an incentive for elderly parents to provide more care to their disabled spouses than they otherwise would. Our first model is based on a "demonstration effect" -- adult children learn from a parent's example that family caregiving is appropriate behavior. Our second model is based on a "punishment effect" -- if the nondisabled spouse fails to provide care for the disabled spouse, then the children may retaliate in the future by not providing care for the nondisabled spouse. Both models predict that spouses in couples without children, as well as those in couples without joint children, will be less likely to provide care for each other than spouses with joint children. Results based on AHEAD data provide support for the latter prediction.