Does Family Caregiving Complement Formal Care? Daughters and Parental Survival After a Severe Health Shock

We study how informal family caregiving and formal care interact after severe parental health shocks, and whether they operate as substitutes or complements. Using Danish administrative data, we compare parents of only children who experience a stroke at the same age and differ only in the gender of their child. Before the stroke, parents of daughters and parents of sons follow similar health trajectories, with comparable levels of pre-existing conditions and healthcare utilization. After the stroke, a survival gap opens and grows, and parents of daughters are 1.5 percentage points more likely to be alive by year five. Over the same period, daughters adjust more than sons along several margins: they become more likely to live near their parents, less likely to be married, and have fewer children, consistent with greater involvement in informal caregiving. Crucially, parents of daughters use more physical rehabilitation, an elective type of formal care that requires sustained engagement. Rather than crowding out formal provision, daughters appear more likely to help parents navigate and use professional services. Informal and formal care can therefore operate, at least in part, as complements in the response to severe health shocks.