Alternative sources of social support and their impacts on institutional risk.

We examined the direct and buffering effects of different dimensions of social support on the risk of being institutionalized over a 2-year period. Multivariate analyses indicated that specific aspects of social support, such as having a spouse or adult child caregiver, or having a caregiving relationship of at least 3 years' duration, moderated the impact of one type of stress (being highly dependent on others for care) on the risk of entering a nursing home. Networks that included a paid provider modestly offset the impact that multiple IADL impairments had on being admitted at least once to a nursing home.