Discrepancies in reports of support exchanges between aging parents and their middle-aged children

Stepfamily Variation in Parent-Child Relationship Quality in Later Life

Objective

We use a family systems approach to examine how stepfamily structure is associated with both positive and negative parent-child relationships while considering mothers' and fathers' discrepant reports.

Background

Two in five older couples with children are in stepfamilies. Past research on later-life stepfamily dynamics has focused mainly on positive aspects of relationships and compared reports of mothers and fathers from different families.

Method

Using the U.S. Health and Retirement Study, we estimated multilevel models with data from married couples in which both spouses reported living children and answered all questions about positive and negative parent-child relationships (N = 2,150).

Results

Couples in stepfamilies reported less positive and more negative relationships with their children than did couples in non-stepfamilies. Mothers reported more positive relationships than fathers, but there was no gender difference in reports of negative relationships. The patterns of perceived parent-child relationships and divergent reports between mothers and fathers also varied by stepfamily structure. Structural complexity was not consistently related to positive or negative relationships.

Conclusion

This study underscores the importance of considering mothers' and fathers' different points of view in the same family and examining both positive and negative parent-child interactions as negative relationships are not merely the reverse of positive relationships.

Will your child take care of you in your old age? Unequal caregiving received by older parents from adult children in Sweden

Intergenerational family care provided to older parents by adult children is growing and differs based on gender and socioeconomic status. Few studies consider these elements in relation to both the parent and their adult child, and little is known about the number of care tasks received even though those providing intensive levels of care are at risk of experiencing adverse consequences in their lives. This study uses data from the nationally representative 2011 Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and includes child-specific information from parents aged 76 years and above. Analyses used ordinal logistic regression and are presented as average marginal effects and predictive margins. Results show that parents in need of care report that one-third of all adult children in the sample provide care to three out of five of them. The care is most often non-intensive, yet nearly one in ten of all children provide more intensive care of two or more tasks. When adjusting for dyad characteristics as well as geographic proximity, results show adult-child gender differences where parents receive more care from manual-working-class daughters than manual-working-class sons. Overall, manual-working-class daughters are most commonly reported as carers among adult children, and they are particularly overrepresented in providing intensive care. We conclude that gender and socioeconomic inequalities exist among care receivers' adult children, even in a strong welfare state such as Sweden. Knowledge about levels and patterns of intergenerational care have important implications for how to reduce unequal caregiving.

Intergenerational Proximity to Aging Parents and Depression Among Married Persons in China

Using data from China Health and Retirement Longitudinal Study (N = 3864), we examined the relationship between proximity to aging parents and depression among middle-aged (45-64 years) married individuals in China. Our study depicted and explained the declining coresident rate and showed a majority of adult children live separately from their parents. Children living in different households had higher levels of depression than coresident children, including those living adjacently. Furthermore, having a coresident spouse increased the levels of depression of sons living in an adjacent dwelling and in the same city, and reduced the levels of depression of daughters living farther away. More intergenerational economic support increased the levels of depression of daughters living in an adjacent dwelling. These findings may offer a reference for married adult children to reconstruct intergenerational proximity and adjust intergenerational relations.

Cohabiting Adult Children's Transfers to Parents in the United States

Objective

This brief report presents national estimates of transfers of time and money from cohabiting adult children (ages 18 to 65) to their parents (own and in-laws) to test whether cohabiting adults give differently from their counterparts.

Background

Previous U.S. studies use data collected in the late 1980s and mid-1990s, when cohabitation was an emerging family form; they find mixed results. Rising rates of cohabitation and an aging population of parents who may rely on transfers from adult children necessitate updated estimates that can help develop the theory of institutionalization of cohabitation.

Method

This study used the 2013 Panel Study of Income Dynamics (PSID) Rosters and Transfers Module, a sample of U.S. households (N=6,340), and logistic and negative binomial models to estimate the likelihood of giving any time or any money to parents by the respondent's union status, the amounts given, and parent type (own, in-laws).

Results

Cohabitors were less likely to give time to their own parents than their never married counterparts, and gave fewer hours, but were more likely to give time and gave more hours than married adults. For financial transfers to own parents, cohabitors and married respondents gave similarly, but both were less likely to give any money than are single respondents. Cohabitators gave more hours to their in-laws than married respondents.

Conclusion

Cohabitors behave somewhere in-between marital "greedy institution" norms and broader norms of solidarity with parents. More work should be done to understand how union status affects transfers to parents.

Perceptions of Closeness in Adult Parent-Child Dyads: Asymmetry in the Context of Family Complexity

OBJECTIVES

Multi-actor data show that parents' and adult children's evaluations of their relation do not necessarily match. We studied disagreement in parent- and child-reported closeness, comparing parent-child dyads involving separated parents, non-separated parents, and stepparents to shed new light on today's diverse landscape of adult parent-child relations.

METHOD

Using data from the Parents and Children in the Netherlands (OKiN) survey, we analyzed closeness in parent-child dyads (N = 4,602) comparing (step)parents' and their adult children's (aged 25-45) reports. To distinguish directional disagreement (i.e., differences in child- and parent-reported means) from nondirectional disagreement (i.e., the association between child- and parent-reported measures), while accounting for absolute levels of closeness, we estimated log-linear models.

RESULTS

All types of parents tend to report higher levels of closeness than their children. Whereas parental overreport is more prevalent among biological father-child dyads than among biological mother-child dyads, we found no differences between biological dyads and stepdyads. The association between children's and parents' reports is higher among dyads involving stepmothers or married mothers than among those involving separated mothers and (step)fathers.

DISCUSSION

The intergenerational stake (i.e., parental overreport) is not unique to biological parent-child relations. Instead, patterns of disagreement seem most strongly stratified by gender.

Families in Later Life: A Decade in Review

Later-life families encompass the legal, biological, romantic, and kin-like relationships of persons ages 65 and older. Research on older families has flourished over the past decade, as population aging has intensified concerns regarding the capacities of families to care for older adults and the adequacy of public pension systems to provide an acceptable standard of living. Shifting patterns of family formation over the past half-century have created a context in which contemporary older adults' family lives differ markedly from earlier generations. Decreasing numbers of adults are growing old with their first and only spouse, with rising numbers divorcing, remarrying, forming non-marital romantic partnerships, or living single by choice. Remarriage and the formation of stepfamilies pose challenges and opportunities as older adults negotiate complex decisions such as inheritance and caregiving. Family relationships are consequential for older adults' well-being, operating through both biological and psychosocial mechanisms. We synthesize research from the past decade, revealing how innovations in data and methods have refined our understanding of late-life families against a backdrop of demographic change. We show how contemporary research refines classic theoretical frameworks and tests emerging conceptual models. We organize the article around two main types of family relationships: (1) marriage and romantic partnerships and (2) intergenerational relationships. We discuss how family caregiving occurs within these relationships, and offer three promising avenues for future research: ethnic minority and immigrant families; older adults without close kin ("elder orphans"); and the potentials of rapidly evolving technologies for intergenerational relationships and caregiving.

Revisiting Intergenerational Contact and Relationship Quality in Later Life: Parental Characteristics Matter

Contact and relationship quality between adult children and aging parents are two widely used indicators of intergenerational solidarity and are often assumed to be positively correlated. However, the association between the two may depend on characteristics of the parent involved. Using Family Exchanges Study Wave 1, this study assessed whether parental difficulties-measured as functional limitations and life problems-and gender moderated the associations between middle-aged adults' contact and relationship quality with their parents. We found that more frequent email or phone contact was associated with worse relationship quality for fathers who had functional limitations. For life problems, however, more contact was not related to relationship quality for fathers with life problems. The associations did not differ by mother's difficulties. These results suggest that frequent contact between middle-aged adult children and aging parents does not uniformly reflect better relationship quality but rather depends on parents' characteristics.

Exploring the experiences of the older adults who are brought to live in shelter homes in Karachi, Pakistan: a qualitative study

Background

The traditional joint family system in a culturally diverse Pakistani society shows great respect and care for older population by the families and their generations. However, in the recent years the phenomenon of population ageing in Pakistan is rapidly increasing due to demographic shift influencing life expectancy, along with changes in socio-cultural values. This transition has resulted in institutionalization of the elderly as an emerging shelter alternative. The aim of this study was to explore the experiences of the elderly people and to identify the reason which compelled them to reside in these shelter homes.

Method

A qualitative methodology, with a descriptive exploratory design, was adopted for the study. A purposive sample of 14 elderly males and females were selected, from two different shelter homes in Karachi, Pakistan. Semi-structured interviews were audio recorded and transcribed. Content analysis was done to extract the themes and comprehend the data.

Results

Content analysis revealed five major themes: the circumstances of leaving home, experiences, and challenges to wellbeing before entering the care facility, coping with challenges, and decision to live in a shelter home. The analysis discovered that the elderly were experiencing lack of physical, psychological, emotional, and financial support from their family and children. It also indicated that migration of children for better career and employment opportunities, entrance of women into the workforce, and insensitive behaviour of children, left the senior citizens neglected and helpless. The findings also uncovered the challenges of unemployment and family disputes that the elderly had to face made them dependent, distressed, helpless, and lonely resulting in both their apparently willing and forceful decision to reside in shelter homes.

Conclusion

The findings point to need for further investigation of the identified areas in this study through qualitative and quantitative researches. There is a dire need for increasing public awareness through the social, electronic, and print media, and providing capacity building training to HCPs for the care of the elderly. The lobbying group can act as a catalyst in persuading the government officials for the execution of a policy on retirement, day care and subsidized provision of health services for the betterment of the elderly.

Accuracy of Adult Children's Perceptions of Mothers' Caregiver Preferences

BACKGROUND AND OBJECTIVES

Most older mothers have strong preferences regarding which offspring will serve as their future caregivers, and violation of these preferences has been found to have consequences for mothers' psychological well-being. However, no study has examined the accuracy of adult children's perceptions of their mothers' caregiver preferences. In this article, we compare mothers' stated preferences for particular caregivers with their adult children's perceptions of their mothers' preferences.

RESEARCH DESIGN AND METHODS

Data were collected from 675 adult children and their mothers nested within 285 families as part of the Within-Family Differences Study.

RESULTS

Only 44.6% of adult children accurately reported their mothers' preferences for particular offspring as caregivers. Consistent with our hypotheses, accuracy was higher when mothers and children shared values regarding filial piety, and lower when children were parents, had poor health, and lived further away. Surprisingly, primary caregivers were substantially less likely to accurately report mothers' caregiver preferences than were noncaregivers. This counterintuitive pattern can be explained by the finding that most mothers were cared for by children whom they did not prefer and may have therefore been reluctant to share their preferences with those caregivers.

DISCUSSION AND IMPLICATIONS

Given the negative psychological consequences for mothers whose caregiver preferences are violated, the high level of inaccuracy found among adult children has important implications when mothers face serious health events. These findings underscore the need for intervention efforts to encourage practitioners and clinicians to collect information directly from mothers regarding preferences for particular offspring as caregivers.

Adult Children's Perceptions of Maternal Favoritism During Caregiving: Comparisons Between Turkey and the United States

This study explores cross-cultural variations in adult children's perceptions of maternal favoritism during caregiving in Turkey and the United States. Qualitative analysis of interview data from two siblings in each of 14 Turkish and 14 American families revealed differences in adult children's perceptions of and explanations for maternal favoritism. Most Turkish children perceived that their mothers favored sons because of higher filial expectations from sons. Conversely, most American children perceived that their mothers favored daughters and explained mothers' preferences as based on socioemotional factors. Furthermore, perceptions of maternal favoritism had detrimental consequences for sibling relationships in both contexts but differently. Turkish daughters reported conflicts over their favored brothers' lack of cooperation. American daughters perceived themselves as favored and felt obligated to undertake most of the caregiving burden which fueled sibling conflict. Taken together, this study highlights the importance of cultural context for understanding the within-family differences in sibling relationships during caregiving.

The Effects of Ageing on Intergenerational Support Exchange: A New Look at the Hypothesis of Flow Reversal

There has been debate about whether the flow of intergenerational support reverses as parents age. One view is that in western countries, parents remain ‘net donors’ to children, even in very old age. Such a conclusion coincides with notions of parental altruism and would be in contrast to notions of exchange and reciprocity over the life course. This paper examines the thesis of flow reversal in a new way: it uses prospective longitudinal data, it combines data from samples of ageing parents and samples of adult children, it develops a way to create measures of balance from frequency items on support exchange, and it combines objective measures of support exchange with subjective perceptions of symmetry. The focus is limited to support that involves time and effort. The support that parents give to children declines with age, the support they receive increases, and at around age 75–76, parents become ‘net receivers’. The decline in downward support is stronger than the increase in upward support, suggesting that declining parental opportunities to give plays an important role in the flow reversal. In sum, the analyses provide evidence for what we can call delayed and parent-driven flow reversal. Evidence for flow reversal is stronger in the sample of adult children, pointing to the limitations of sampling ageing parents. Finally, there is correspondence between objective measures of support exchange and perceptions of symmetry, although on the whole, few parents regard themselves as ‘net receivers’.

The Economic Organization of Extended Family Households by Race/Ethnicity and Socioeconomic Status

This study examines differences in the amount of economic support or mutual benefit derived from extended family living arrangements by studying differences in monetary contributions to essential household expenditures across family units in extended family households. Using the 2008 Survey of Income and Program Participation, multivariate regression and selection models are estimated to assess racial differences in family contributions toward household expenses in extended family households. Extended family households have very unequal monetary contributions towards household rent and utilities, although Hispanics have less unequal monetary contributions compared to other racial groups. Hispanic and Asians extended family households experience decreasing inequality in financial contributions as the income of each family increases whereas no relationship between financial contributions and income is found for whites or blacks. This suggests a different cultural orientation to extended family living arrangements for Asians and Hispanics compared to non-Hispanic whites.

Intergenerational Transfer and Reporting Bias: An Application of the MIMIC Model

Objectives

Parents' and adult children's reports of transfer do not always agree, because each has respective bias. This study demonstrates a method to separate reporting bias from transfer and identify their respective correlates.

Method

The analysis was based on 4,947 parent-child dyads from the Family Roster and Transfer Module added to the 2013 wave of the Panel Study of Income Dynamics. Drawing on classical test theory, a multiple-indicators-and-multiple-causes (MIMIC) model was used to decompose parents' and adult children's reports of time and money transfers into a latent factor (true transfer) and unique factors (bias). This model further identified respective covariates associated with true transfer and bias.

Results

A substantial amount of bias existed in parents' and adult children's reports. The self-enhancement hypothesis did not fully explain how resources to help and need for support relate to the direction of reporting bias. Some correlates of transfer identified in prior studies were associated with transfer only, some with bias only, and others with both transfer and bias.

Discussion

Bias is common in both parents' and adult children's reports of transfer. Separating bias from transfer and identifying their respective correlates makes it possible to explain why intergenerational transfer and reporting bias occur.

Adult Children's Serious Health Conditions and the Flow of Support Between the Generations

Purpose

The life course perspective suggests that serious physical or mental health conditions that limit the daily activities of any one family member are likely to be consequential for other family members as well. In this article, we explored whether adult children's serious health conditions affected the flow of expressive and instrumental support between mothers and both the offspring with health conditions and other offspring in the family.

Design and Methods

We used data collected from 369 older mothers (M = 78 years) regarding 1,338 of their adult children (M = 49 years), as part of the Within-Family Differences Study-II.

Results

Adult children with serious health conditions were more likely than their siblings to be given support by their mothers. The presence of adult children with health issues did not reduce mothers' provision of expressive or instrumental support to their children without health conditions. However, in families in which a higher proportion of children had serious health conditions, mothers received expressive support from a greater proportion of their healthy adult children than in families with a smaller proportion of adult children with health conditions.

Implications

These findings contribute to a growing body of research demonstrating the ways in which conditions in adult children's lives affect their mothers.

A Qualitative Study of the Experiences of Parents With an Adult Child Who Has a Severe Disease: Existential Questions Will Be Raised

A prominent existential concept is that elderly parents should naturally become severely ill or die before a younger person does. If the reverse should happen, it may influence the parent's existential view of life. The aim of this study was to investigate the existential issues during illness time. This was a qualitative study with in-depth interviews and was conducted in a University Hospital in western Sweden. Eleven parents agreed to participate in individual interviews at baseline and 1 year later. The total number of interviews completed was 19. The study identified 5 areas according to an existential perspective: life took the wrong path, the age of the child, difficult to see the child as sick, worrying about the child, and the relationship with the adult child. Existential questions are often present in those circumstances and can be raised in conversations with parents. Existential questions began to arise for the parent when the child was diagnosed with the severe illness. The situation of having a severely ill child caused both fear and anxiety that the worst-case scenario they could imagine, that the child will die, might happen. Further research is required on this rarely investigated subject of having an adult child with a severe disease.

Predictors of Discrepancy Between Care Recipients With Mild-to-Moderate Dementia and Their Caregivers on Perceptions of the Care Recipients' Quality of Life

PURPOSE

The goal of this study was to explore predictors of discrepancy between reports of caregivers (CGs) and care recipients (CRs) with mild-to-moderate dementia about CRs' quality of life (QOL).

DESIGN AND METHODS

This study was a secondary analysis of cross-sectional data drawn from a study of 200 care dyads of CRs with mild-to-moderate dementia and their primary family CGs. Paired t test, ordinary least squares multiple regression, and binary logistic regression were used for the analyses.

RESULTS

Caregivers rated CRs' QOL significantly lower (worse) than CRs did. Ordinary least square regression results showed that greater incongruence in perceptions of CRs' decision-making involvement (DMI) and higher level of CR impairment in activities of daily living were significantly related to higher absolute discrepancy between CG and CR about CRs' QOL. In the logistic models, when the dyad had more DMI incongruence, or CG reported higher relationship strain, the CG was more likely to report a lower CR QOL than CR reported.

IMPLICATIONS

Practitioners should consider incorporating CRs' perspective when planning care instead of solely depending on CGs' perspective. Also, practitioners should pay attention to any gap between perceptions of CGs and CRs, particularly with regard to CRs' QOL.

Parental Knowledge: Examining Reporter Discrepancies and Links to School Engagement Among Middle School Studies

It is well established that parental knowledge contributes to adolescents' well-being and school success and scholars have noted that parents and adolescents report different levels of knowledge. Discrepancies in parental knowledge have implications for adolescent outcomes such as risk behaviors, but little is known about the implications of knowledge discrepancies for adolescents' school outcomes. The present study examined discrepancies in parent and adolescent reports of parental knowledge and investigated the extent to which knowledge discrepancies were linked to school engagement. Participants were early adolescents (N = 174; 53 % female) and their parents (90 % mothers). Adolescents (57 % African American/Black, 18 % multiracial, 17 % White/Caucasian, 7 % Hispanic/Latino and 1 % Asian American) attended a Midwestern, Title 1, urban, public middle school. Adolescents completed surveys in their homerooms and parents completed paper-pencil surveys at home or surveys via telephone. Results showed that parents reported more knowledge of adolescents' activities and whereabouts compared to adolescents' reports. Knowledge discrepancies were associated with school bonding and school self-esteem such that dyads in which adolescents reported more knowledge than their parents reported had significantly higher levels of school bonding and school self-esteem compared to dyads in which parents reported much more knowledge.

Intergenerational financial exchange and the psychological well-being of older adults in the Republic of Korea

OBJECTIVES

This study examined whether the exchange of instrumental support (i.e., financial resources) among older adults and their children was related to the psychological well-being of older Koreans.

METHODS

Data from the Korean Longitudinal Study of Ageing were employed. Older adults who were aged 65 and older and who had at least one living child who did not live in the respondent's household were included (N = 3791). Well-being was measured with depressive symptoms (CES-D-10) and life satisfaction. For the direction model of exchange, giving and receiving support was assessed with financial aid (cash and non-cash). For the reciprocity model of exchange, four patterns of financial exchanges were identified: both giving and receiving, receiving only, giving only, and no exchange.

RESULTS

The results from the direction model showed that older adults who give financial support were less likely to be depressed and reported higher levels of life satisfaction. The effect of receiving support was not significant for depression but was related to higher levels of life satisfaction. The results from the reciprocity model showed that those who gave and received support had better psychological health compared to those who only received support.

CONCLUSIONS

Both giving and receiving were positively related to the psychological well-being of older adults. Our results provide support for identity theory and equity theory as frameworks for understanding intergenerational exchange and well-being of older Koreans.

Young Adults' Provision of Support to Middle-Aged Parents

OBJECTIVES

Middle-aged adults often provide support to aging parents, but researchers know little about support that young adults provide middle-aged parents. This study examined support that young adults provide parents and explanations for that support from both offspring's and parents' perspectives.

METHOD

Young adults (n = 515, mean age = 22.34) and their parents (n = 364, mean age = 50.09) from the Family Exchanges Study reported support that offspring provide parents. Participants also reported parental personal problems, parental disability status, relationship quality, and support that parents provide offspring.

RESULTS

Offspring provided parents with emotional support and listening more often than other forms of support. Offspring reported providing more frequent support than parents reported receiving. We examined factors associated with support using multilevel models. Both offspring and parents reported more frequent support provided to parents when they had higher quality relationships and when parents gave more frequent support to offspring. Offspring (but not parents) reported providing more frequent support to parents when parents were disabled.

DISCUSSION

Findings are consistent with solidarity theory, which suggests that high-quality relationships may explain support. The concept of self-enhancement and generativity in middle-aged parents may explain the intergenerational differences in the association between parental disability and support.

Who provides care? A prospective study of caregiving among adult siblings

PURPOSE

We use data from a longitudinal, within-family study to identify factors that predict which adult siblings assumed caregiving responsibilities to older mothers over a 7-year period.

DESIGN AND METHODS

Data for the study were collected from 139 older mothers at 2 points 7 years apart regarding their expectations and experiences of care from 537 adult children.

RESULTS

Children whom mothers identified at T1 as their expected future caregivers were much more likely to provide care when a serious illness occurred. Caregiving offspring were also more likely at T1 to have shared their mothers' values, lived in proximity, and to be daughters.

IMPLICATIONS

The findings indicate the degree to which a mother's expectations for care predict actual caregiving by that child. Practitioners working with older adults should explore parents' expectations for future care that involves their adult children.

Discrepancy in reports of support exchanges between parents and adult offspring: within- and between-family differences

Using data from 929 parent-child dyads nested in 458 three-generation families (aged 76 for the oldest generation, 50 for the middle generation, and 24 for the youngest generation), this study investigated how discrepancies in reports of support that parents and their adult offspring exchanged with one another vary both within and between families, and what factors explain variations in dyadic discrepancies. We found substantial within- and between-family differences in dyadic discrepancies in reports of support exchanges. For downward exchanges (from parents to offspring), both dyad-specific characteristics within a family (e.g., gender composition, relative levels of relationship quality, and family obligation) and shared family characteristics (e.g., average levels of relationship quality) showed significant effects on dyadic discrepancies. For upward exchanges (from offspring to parents), however, only dyad-specific characteristics (e.g., gender composition, coresidence, relative levels of positive relationship quality, and family obligation) were significantly associated with discrepancies. Discrepancies in support exchanges were mainly associated with dyad-specific characteristics, but they also appeared to be influenced by family emotional environments. The use of multiple informants revealed that families differ in discrepancies in reports of exchanges, which has implications for quality of family life as well as future exchanges.

Parental support during young adulthood: Why does assistance decline with age?

Previous research has found that financial transfers from parents to young adult children decline as children age and that age is one of the strongest predictors of support. Using data collected from young adults (ages 18 to 34) and their parents (ages 40 to 60; N=536 parent-child dyads), we explore the possibility that the relationship between age and financial support is mediated by offspring needs, acquisition of adult roles, or geographical and emotional closeness. We find that age-related declines in offspring's needs help to explain why financial support falls with age. However, offspring age remains a robust predictor of financial support after controlling for a wide range of factors, suggesting that age norms condition support from parents to offspring.

Linking concurrent self-reports and retrospective proxy reports about the last year of life: a prevailing picture of life satisfaction decline

OBJECTIVE

We examined the extent to which retrospective proxy reports of well-being mirror participant self-reports at 12-24 months before death and how proxy reports of well-being change over the last year of life. We also explored the role of sociodemographic, cognitive, and health factors of both participants and proxies in moderating such associations.

METHOD

We used retrospective proxy ratings obtained in the German Socio-Economic Panel Study (N = 164; age at death = 19-99 years).

RESULTS

Results revealed moderate agreement between self- and proxy reports (r = .42), but proxies, on average, overestimated participants' life satisfaction by two thirds of a scale point on a 0-10 scale (or 0.4 SD). Discrepancies were particularly pronounced when proxies themselves reported low life satisfaction. Over the last year of life, participants were viewed to have experienced declines in life satisfaction (-0.54 SD). Declines were stronger for ill participants and proxies who reported low life satisfaction.

DISCUSSION

Results qualify theoretical expectations and empirical results based on self-report data that are typically available 1 or 2 years before death. We discuss that retrospective proxy reports in panel surveys can be used as a hypothesis-generating tool to gather insights into late life.