Population aging in the United States is increasing the number of people with long-term health problems and
other care needs, leading to a crisis in long-term care (Bipartisan Policy Center 2014). Family care is a central
component of the long-term services and supports system, and adult children are the most common providers
of that care for frail older parents (Spillman et al. 2014). Geographic proximity between parents and adult
children is an important determinant of informal care provision (Choi et al. 2015).
This project uses data from the Health and Retirement Study on the geographic proximity between a respondent
age 65 and older and each of their adult children, combined with information about whether each child provides
any care for a parent who has care needs due to function limitations or cognitive decline. We obtain information
about aging services organizations from the Urban Institute’s National Center for Charitable Statistics data and
the HRS contextual data. Our approach combines theoretical insights from altruism models commonly used in
the literature on parent-child transfers and support with insights from the migration literature used to
understand location decisions. We address the following specific aims:
Aim 1: Estimate separate reduced form models of the geographic proximity of adult children to their older
parents as well as caregiving conditional on parental care needs (i.e., having a functional limitation and/or a
cognitive impairment) as a function of parent and child economic and socio-demographic characteristics,
characteristics of parent-child dyads, and characteristics of place, such as demographic composition, labor
market opportunities, housing affordability, and availability of aging service organizations and care services.
Aim 2: Model changes in geographic proximity between adult children and older parents as a function of
changes in parent’s health and functional status and the same set of variables described above.
Aim 3: Jointly model caregiving and location decisions (conditional on the need for care) to account for the
interdependence of the two processes. This analysis would help us understand how the determinants of care
might differ when residential proximity is modeled jointly with care decisions. This approach allows us to assess
the role of characteristics of place, such as the supply of formal aging support and care services, as well as family
and individual characteristics in shaping decisions about a child’s care provision and location.
We have a particular focus on understanding these joint processes for parents whose care needs come from
Alzheimer’s disease or related dementia. We also focus on differences by gender, race, and SES.