Shifting Preferences for Aging in Place: The Role of Health, Childlessness, and Income Among Older Adults in Korea

Background and Purpose. Aging in place is a central objective of community-based long-term care for older adults in Korea. However, limited research has examined whether Korean older adults’ living arrangement preferences remain stable or shift with declining health, or how these preferences vary based on child availability. This study examines (1) older adults’ preferred living arrangements based on their projected health status (i.e., when healthy versus when ill), (2) the effect of childlessness on these preferences, and (3) whether the effect of childlessness differs by the level of household income.

Methods. We draw on data from the 2023 National Survey of Older Koreans, a nationally representative cross-sectional study of South Koreans aged 65+. Using binary logistic regression models, we predict the odds of moving to a senior housing (as opposed to living in one’s own home) when one remains healthy. We then use multinomial logistic regression models to predict the odds of moving to different housing options (moving closer to a relative, moving to a private senior housing, moving to a long-term care facility supported by the government insurance) as opposed to continuing to live in the current home when health deteriorates. For both models, we examine the interaction between childlessness (1= childless, 0 = has a child) and income (1 = at or above median income, 0 = below median income).

Results. Our data show that, although a majority of both childless and non-childless older adults want to live in the community when they are healthy, compared to older adults with children, childless older Koreans are more likely to prefer senior housing. However, the gap between childless and non-childless older adults is reduced among those with higher income. When health deteriorations are expected, compared to those who have children, childless older adults are less likely to want to move in with or near children or other relatives, more likely to prefer private senior housing, and less likely to prefer long-term care facilities than to live at home. In the multinomial logistic regression models, income shows a significant interaction effect in predicting only one outcome - the odds of liking private senior housing as opposed to staying home. Compared to their peers with children, childless older adults prefer to stay in private senior housing, but this gap is reduced among those who have higher income.

Conclusions and Implications. Given higher preferences for private senior housing among older Koreans without children, needs for senior care communities that combine services such as prepared meals, leisure activities, and access to health care will likely increase in the future. Providing subsidies or tax incentives to developers and service providers and creating financial assistance programs for low-income populations may make the senior living more affordable and accessible. In addition to new housing, efforts should be geared towards modifying existing homes and arranging sufficient services at home, as these arrangements may make aging in place more feasible for both childless and non-childless older Koreans.