Older people's ability to thrive independently of their adult children is an important feature of a universalistic welfare system. However, population ageing puts this notion under stress. In separate multinomial logistic regression models for older men and women, we examined whether adult children's gender, number and proximity were associated with older parents’ relocations into residential care facilities, and whether the effects of these children's characteristics on older parents’ institutionalisation vary by parents’ severe health problems, operationalised as closeness to death – specifically, dying within the two-year observation period. Analyses were based on the Swedish register data between 2014 and 2016 (N = 696,007 person-years). Older parents with at least one co-resident child were less likely to move or become institutionalised than those without a co-resident child. We did not find a relationship between older adults’ institutionalisation and the closest child's gender. The negative effect of having a non-resident child living nearby on the likelihood of becoming institutionalised was more pronounced for mothers than fathers. Having a child nearby decreased the likelihood of moving to an institution more for mothers who had severe health problems than for those in better health. We found no evidence of a relationship between number of children and likelihood of institutionalisation.