Adriana Reyes
Assistant Professor of Policy Analysis and Management, Cornell University
Summary of initial project: Adult children provide significant amounts of caregiving to their parents, which is facilitated by relatively close geographic proximity. This project utilizes longitudinal data from the Health and Retirement Study (HRS) to understand how families mobilize in response to a health shock, such and ADRD diagnosis. Using data from 2004-2014, we estimate proximity over time between parents and their adult children using parent’s Census tract and children’s zip codes. Analyses will leverage longitudinal data to assess the time-ordering of health shocks and changes in geographic proximity to children using fixed effects models.
Rationale for broadening initial project: Alzheimer’s disease and related dementias (ADRD) are among the costliest conditions faced by individuals and society [1]. Average out of pocket costs for someone with ADRD is over $10,000, four times as much as for someone without ADRD [2]. Older adults with ADRD are at a greater risk of preventable hospitalizations [2, 3]. Out-of-pocket health care payments for ADRD consumed 32% of household wealth five years before death [4]. Early stage of diagnosis of ADRD has been associated with declines in wealth, which may make it difficult to pay for late-stage treatment [5]. Despite the well documented financial toll of ADRD on the families of those living with ADRD, we know less about how family proximity and care may moderate this relationship.
Aim: This project asks whether changes in parent-child proximity in response to ADRD is associated with wealth. In particular, does the proximity of adult children reduce health care-related spending for adults with ADRD? The overall goal of this work is to understand how family proximity and mobilization are associated with wealth trajectories and health care spending by older adults with ADRD. Having family nearby may help reduce hospitalizations and other forms of health care spending that can enable older adults to maintain wealth.