Cohort Differences in the Availability of Informal Caregivers: Are the Boomers at Risk?

In 2030, the first of the Baby Boomers (BBs) will turn 85 years old and transition into the period of the life course when the need for care increases. It is imperative that we understand the implications for new policies and programs to provide anticipated care for these older Boomers if this cohort has few informal care providers available. By 2050, all surviving BBs will be among the oldest old. A U.S. Census report (Vincent & Velkoff, 2010) projects that the 85+ population in 2050 will be more than three times greater than it was in 2010 . With the projected numbers of older adults paired with increasing life expectancies, the demand for formal and informal care among aging adults is expected to grow over the next few decades. Estimates of the amount of informal care that older adults receive have ranged from 4.6 hr per week for those with normal cognitive functioning (Langa et al., 2001) to more than 50 hr per week for adults suffering severe cognitive impairment or for those in the year preceding death (Ernst & Hay, 1994; Max, Webber, & Fox, 1995; Rhee, Degenholtz, Lo Sasso, & Emanuel, 2009). Informal care typically is provided by the spouse or adult children (Boaz & Hu, 1997; Freedman, Aykan, Wolf, & Marcotte, 2004; Silverstein & Giarrusso, 2010; Spillman & Pezzin, 2000; Wolff & Kasper, 2006). Boaz and Hu (1997) found that in particular, married adults received significantly more informal care than unmarried adults and that those individuals who received care from both a spouse and adult children tended to have the most successful outcomes. In a sample of Swedish older adults living alone, Larsson and Silverstein (2004) found that those who were parents were significantly more likely to receive informal care compared with nonparents. Given the proportion of informal care from spouses and children, it is important to ask about potential informal care resources of the BB cohort (born between 1946 and 1964). Demographic changes in the population may make this group more vulnerable to an informal care supply gap in late life than earlier cohorts, reflecting a combination of cohort-specific marriage and fertility choices in early life and historical changes in marital history, longevity, spousal and child survival, coresidence patterns, the geographic proximity of a potential child caregiver, and the alternative availability of extended family and nonkin informal carers. We focus on marital status and child availability and adopt a life course perspective to compare cohorts. As a first step, we used a population-level approach to examine cohort differences and similarities in potential informal care resources at periods that are typically prior to actual need, namely midlife and young old age. The aim was to identify an older birth cohort similar to the BB in terms of fertility and marital status, given the consistent finding that the two primary sources of informal care are spouses and children. To do this, we use data from the U.S. Census and the Health and Retirement Study (HRS) to characterize static cohort differences and similarities in marital status and availability of an adult child at two periods in the life course, midlife and young-old age. The goal of this descriptive comparison is to determine if a previous cohort can be identified as a model for the BBs at periods in the life course when the need for informal care is typically low. In particular, we expected the cohort of Depression and WWII parents (DWP; 1905–1921) to be more similar to the BB than the parents of BBs (PBB; 1922–1940), in terms of the availability of a spouse and adult children in late life, albeit for different historical reasons. Entry to marriage and childbearing was constrained for the DWP cohort during the boom and bust years between 1925 and 1945. In contrast, the PBB cohort experienced strong normative pressure regarding marriage and fertility after WWII when there were unprecedented opportunities for home ownership and new lifestyles. The marriage and fertility choices of the BB are more heterogeneous, associated with the introduction of reliable birth control and increased workplace participation of women (e.g., Furstenberg, 2010; Hareven, 1994; Stanger-Ross, Collins, & Stern, 2005). Next, we apply generalized linear mixed models to longitudinal cohort panel data to examine cohort differences in changes in the availability of a spouse and an adult child in close proximity across the transition from midlife to old age. We compare the trajectories of potential informal care resources between the DWP and PBB cohorts across old age using longitudinal data from HRS. Specifically, we investigate three research questions. First, does the likelihood of being married and of having an adult child living within 10 miles change as individuals’ age? Based on previous research, we hypothesized that the likelihood of marriage will decline over time due to the transition into widowhood and that the likelihood of having a grown child living nearby will increase with age due to mutual filial desires and obligations (Silverstein, Gans, & Yang, 2006). Second, does the likelihood of being married and of having an adult child living within 10 miles differ by birth cohort, over and above any effects of age, education, gender, race, and health? We hypothesize that the DWP cohort will be less likely to be married and will also be less likely to have a grown child living nearby compared with the PBB cohort. Finally, do the rates of age-related change in the likelihoods of being married and having a geographically proximal grown child differ by birth cohort? Overall, our expectation was that for the specific indicators we examined, the DWP cohort might be considered a model of available informal care resources for the Boomers as they enter late life.