Academic journal article Population

The Family Networks of People Aged 60 and over Living at Home or in an Institution

Academic journal article Population

The Family Networks of People Aged 60 and over Living at Home or in an Institution

Article excerpt

Improved life expectancy in France, although accompanied by a decline in the proportion of years lived without disability (Robine et al., 1994), is responsible for an increase in the number of dependent elderly people that is due to accentuate with the aging of the baby-boom generations (Désesquelles, 1999). This prognosis raises the question of care provision for cases of dependency, which in turn leads to the familiar choice between continued living at home and "placement" in an institution. Among more than twelve million people aged 60 and over enumerated in France in the 1999 Census (Courson and Madinier, 2000), close to 500,000 lived in medical and social institutions(1). Deterioration in health status plays a decisive role in placement in an institution, but other factors are certainly also involved. Foremost among these are insufficient available help, whether professional or informal; inadequate resources; and unsuitable housing (Metzger et al., 1997; Simon and Fronteau, 1999). Given that assistance to dependent persons is very often provided by a family member (Renaut et al., 1995; Dutheil, 2001), we expect that people without families able to provide this assistance, for whatever reason (lack of family or broken family ties, geographical distance, incompatibility with work, etc.), are more likely, other things being equal, to reside in institutions.

The results of the Disability, Functional Limitations, Dependency survey (Handicaps-Incapacités-Dépendance, or HID survey for short) conducted by the French National Institute of Statistics (INSEE) (Mormiche, 1998) make it possible to verify this hypothesis. In 1998, close to 15,000 people living in medical and social institutions were interviewed about their disabilities and about their family environment. One year later, slightly over 17,000 people living in private households answered the same questionnaire (see Appendix). We thus have information with which to describe and compare the family networks of people aged 60 and over depending on their living arrangements (household or institution). The information gathered by this survey, however, led us to adopt a restrictive definition of family: the data are limited to the respondent's partner(2), children and grandchildren, siblings, and parents and grandparents. We know nothing about the children-in-law, siblings-in-law, or great-grandchildren that respondents may have.

Finally, it should be noted that the respondents were questioned about their living descendants, ascendants, and siblings. The family network to be described is therefore the possible locus of more or less frequent exchanges (visits, telephone conversations, correspondence, various kinds of help). To study the impact of the network on the respondents' living arrangements, we will first describe the "potential" networks of people aged 60 and over, and then examine the networks in action, again comparing people living in private households with those living in institutions.

I. The "potential" family network

1. Marital status and current union status

Among people aged 60 and over who live in private households, 64% are married, as against only 9% of the same age group who reside in institutions (Table 1). Comparing the proportion of people who live as a couple (married or not) gives very similar results: 65% of people living in private households are in a union, as opposed to 8% of those in institutions. In private households, 98% of married people live as a couple while 96% of unmarried people do not; in institutions, the respective proportions are 81% and 99.6%(3).

Table 2 indicates the proportion of people living in an institution in each ten-year age group, by sex and legal marital status. Relative to married people, this population has a clear over-representation of widowed, separated, divorced, and most notably single people. Fewer than 1% of married people live in institutions as against 13% of single people, 9% of widows and widowers, and 5% of separated or divorced people. …

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