Balancing Formal and Informal Caregiving Resources for Older Adults: The Role of Spatial Proximity of Family

To explore how informal and formal home care was balanced for older adults under the weakening informal caregiving systems due to sociodemographic changes in South Korea, this study examined the relationship between the two types of care and the effects of proximity to family caregivers on them.

We analyzed adults aged 65 years and older from the 7th wave of the Korean Longitudinal Study of Aging (n = 722) with limitations in activities of daily living or instrumental activities of daily living or dementia. Multinomial logistic regression was adopted to analyze the impact of family structure on the choice of informal caregivers. Two-stage least squares, Heckman, and IV-Heckman models were applied to address endogeneity and sample selection biases.

The results demonstrated that spouses and children close to older parents appeared to be primary caregivers. According to the IV-Heckman model, informal care substitutes for formal home care (b = -0.416, p < .01), and both being married (b = 0.715, p < .01) and proximity to children within 1 hr (b = 0.888, p < .01) appeared to facilitate formal home care use.

This study reveals that informal and formal home care are inextricably linked. Spouses and adult children close to parents play a pivotal role in directly providing informal care and indirectly facilitating formal home care. Balancing informal/formal home care should be considered in medium- and long-term plans to improve older adults' well-being and reduce formal care's financial burden.