Long-term care dependency and intergenerational living arrangements of elderly households: evidence from China

Using panel data from the China Health and Retirement Longitudinal Study from 2011 to 2018, we examine the impact of long-term care (LTC) dependency on the intergenerational living arrangements of elderly households, including co-residence, adjacent residence, and long-distance residence. We find that elderly households with disabled members are more likely to co-reside with their adult children, while the likelihood of adjacent residence decreases. This trend intensifies with increasing disability severity. Only households with severe LTC dependency reduce the possibility of long-distance residence. The observed increase in co-residence is largely attributable to the relocation from adjacent residences to co-residence. The substitution effects of spousal assistance and LTC insurance pilot programmes reduce the need for co-residence with children. The gravitational effects of economic incentives and Confucian filial piety increase the possibility of co-residence with children. These findings suggest that policymakers could, on the one hand, expand the LTC subsidy range to include family caregivers, and on the other hand, promote co-residence through incentives and cultural advocacy to jointly strengthen formal and informal support networks in addressing LTC dependency.