Future expectations of receiving care and all-cause mortality among older adults in Korea.

Abstract

While demand for care-giving is increasing rapidly among older adults in Korea, there are large unmet care needs. In the face of an elder care crisis, older adults feel uncertain about how and by whom they will be cared for. This study examines the relationship between expectations of receiving care in the future and all-cause mortality among Korean older adults. We explore whether mortality risk differs by sources of care (non-family vs. family caregivers), and further disaggregate different sources of care by family member type (spouse, sons and daughters). Using data from the Korean Longitudinal Study of Ageing (N=3,111 participants aged 65 or older), we estimate Cox proportional hazards regression models predicting all-cause mortality. Expecting to receive care from either non-family or family members is significantly associated with lower mortality risk. Expecting care from a spouse and/or daughter was associated with lower mortality risk, but expecting care from sons was not. After adjusting for covariates, expecting future care from a spouse and/or daughter predicted lower mortality risk (HR=0.83; 95% CI=0.71-0.97 [spouse], HR=0.79; 95% CI=0.67-0.94 [daughter]), and the coefficient for expectations of formal care from non-family members became statistically insignificant. After controlling for family structure, only the association between expecting care from daughters and mortality remained statistically significant (HR=0.78; 95% CI=0.66-0.94). These effects are more pronounced among women than men. Initiatives to support and maintain high-quality family relationships across the life course and remove barriers that obstruct family members from providing care to their elders would improve older adults' longevity.