Aging, Health, and Care: the Geography of Residential Proximity Between Parents and Adult Children

老龄化、健康和护理：父母和成年子女之间的居住邻近地理

• 批准号: 10211093
• 负责人: Stipica Mudrazija
• 金额: $ 99.72万
• 依托单位: URBAN INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10211093
• 关键词: Address; Adult; Adult Children; Age; Aging; Altruism; Alzheimer' s Disease; Alzheimer' s disease related dementia; Attention; Caring; Characteristics; Child; Child Care; Complement; Complex; Data; Data Files; Dementia; Deterioration; Dimensions; Economics; Emotional; Ethnic Origin; Etiology; Family; Geography; Government Agencies; Health; Health Status; Health and Retirement Study; Healthcare; Heterogeneity; Housing; Impaired cognition; Incentives; Individual; Institutes; Joints; Knowledge; Literature; Location; Long-Term Care; Modeling; Nature; Outcome; Parents; Persons; Policies; Process; Race; Respondent; Role; Sampling; Services; Shapes; Social Work; Socioeconomic Status; Source; Spouses; Support System; United States; Variant; aging in place; aging population; base; care outcomes; care providers; care systems; caregiving; functional status; gender difference; health care service; health data; human old age (65+); informal care; insight; instrumental activity of daily living; migration; residence; response; service organization; sociodemographics; statistics

Abstract/Project Summary 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.

摘要/项目摘要 美国的人口衰老正在增加长期健康问题的人数 其他护理需求，导致长期护理危机（2014年两党政策中心）。家庭护理是中心 长期服务和支持系统的组成部分，成年子女是最常见的提供者 对年龄较大的父母的照顾（Spillman等，2014）。父母与成人之间的地理位置 儿童是对非正式护理规定的重要决定性（Choi等，2015）。 该项目使用有关响应之间地理距离的健康和退休研究的数据 65岁及以上的年龄及其每个成年子女，再加上有关每个孩子是否提供的信息 由于功能限制或认知能力下降而对父母有关怀需求的任何护理。我们获得信息 关于城市研究所国家慈善统计数据中心的老化服务组织以及 HRS上下文数据。我们的方法结合了通常使用的利他主义模型的理论见解 有关亲子转移和支持的文献，并通过迁移文献的见解曾经 了解位置决策。我们解决以下具体目标： AIM 1：估计成年子女地理邻近地理邻近模型的单独缩小形式模型 父母以及有条件的父母护理需求（即有功能限制和/或 认知障碍）作为父母和儿童经济和社会人口统计学特征的函数， 亲子二元组的特征和位置的特征，例如人口组成，劳动 市场机会，住房可用性以及老化服务组织和护理服务的可用性。 AIM 2：成年子女与年长父母之间地理接近的模型变化， 父母的健康状况和功能状态的变化以及上述相同的变量集。 AIM 3：共同模拟护理和位置决策（条件是需要护理的条件） 这两个过程的相互依赖性。这种分析将有助于我们了解护理的决定者 当居民的接近性与护理决策共同建模时，可能会有所不同。这种方法使我们能够评估 位置特征的作用，例如正式的衰老支持和护理服务的供应以及家庭 以及在制定有关儿童护理提供和位置的决定中的个人特征。 我们特别着眼于理解这些关怀需求来自的父母的共同过程 阿尔茨海默氏病或​​相关痴呆症。我们还专注于性别，种族和SES的差异。