Geographic Proximity of Family Members and the Provision of Unpaid and Paid Care for Older Adults Not Living With a Spouse: A Cross‐Sectional Study

Background and Aims This study examines the association of family geographic proximity with probabilities of older adults who do not live with a spouse receiving family, unpaid non‐family, and paid care. Methods Restricted geographic sample person and other person files from Round 5 of the National Health and Aging Trends Study (NHATS). We calculated descriptive statistics and estimated multivariate logistic regressions with the primary outcome of whether a respondent who did not live with a spouse received help from a family member and secondary outcomes of receiving help from an unpaid non‐family member or paid worker ( n = 2084). Geographic proximity of family members was defined by family living in the same urban area or, for those not in urban areas, the same county. Results 86.4% of the study sample had family in the same geographic area. Those with a family helper were more likely to have family living in the same geographic area compared to those without a family helper (88.7% vs. 73.3%, p < 0.001). In adjusted models, respondents with at least one family member in the same geographic area had significantly higher odds of receiving help from family (OR = 2.03, p = 0.006) but no difference in receipt of unpaid non‐family help (OR = 1.12, p = 0.682) or paid help (OR = 0.73, p = 0.257). Conclusion When family members live nearby, older adults who do not live with a spouse have a higher probability of receiving support from family members; however, if they do not have family nearby, there is no greater likelihood that they will have unpaid non‐family or paid support. Older adults who do not live with a spouse need more program and policy support, especially if they do not have family nearby.