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Older adults and their children move closer together after health issues

By Shereen Lehman

NEW YORK (Reuters Health) - Seniors who have a stroke or heart attack are more likely to end up living closer to their adult children afterward, according to a new study.

Adult children often serve as informal caregivers when their parents become disabled after an illness, researchers note. But living far apart can make caregiving more difficult.

“This study shows a major health problem of an older person - like a stroke - leads to a significant increase in the family relocation for closer residential proximity between (family members who don’t live together),” HwaJung Choi told Reuters Health in an email. She led the study at the University of Michigan in Ann Arbor.

“This suggests that the growing older population with disability in the U.S. and elsewhere can have a significant effect on residential choices of both older adults and their middle-aged children,” Choi said.

Cardiovascular disease is among the leading causes of disability, the researchers write.

For their report, they analyzed information from a large health and retirement study. The roughly 6,000 participants included 609 older adults who had their first heart attack or stroke or were diagnosed with heart failure between 2004 and 2008.

Among that group, 90 percent of the respondents had at least one living child, and about one in four lived with a child prior to developing cardiovascular disease. Just under half had a child who lived separately but within 10 miles or in the same zip code.

Six percent of those respondents had their nearest child more than 500 miles away, according to findings published in the Journals of Gerontology, Series B.

Over a two-year period, the probability of seniors and their adult children moving closer together was 14 percent when parents experienced a heart attack, stroke or heart failure. That compared to just under 10 percent when parents did not develop cardiovascular disease.

Families of seniors without a living spouse were more likely to move closer together, the researchers report.

Choi noted that when older adults live close to their adult children, it reduces the likelihood that the parents will end up in a nursing home. Where adult children are living could be taken into consideration in community-based care systems that try to keep seniors out of nursing facilities, she said.

But, she added, finding the right time to move is difficult for all family members.

“After a major health deterioration of an older family member, some families at a distance might face great financial and non-financial cost because of necessary relocation,” she said, adding that this applies whether it is the older person or another family member who moves.

Technology such as mobile health monitors could help assist elderly people who are still living alone, Choi said. For example, the devices can send automated updates on the status of people with diabetes to caregivers outside the home.

“For families who live at a distance, technology for monitoring those older adults’ health and functionality within their homes, and in real time communicating that information to both healthcare providers and family, could delay relocation,” Choi said.

“Most Americans want to live independently in the community for as long as possible and avoid being a burden on their families when their health declines,” Michal Engelman told Reuters Health in an email.

Engelman is a sociologist at the University of Wisconsin-Madison. She was not part of the new study.

“Entering a nursing home is also something that most people would rather avoid,” she said.

“If we want to promote care by proximate family members, it's important to have supports in place both for the older person who needs assistance with daily activities and for their usual care providers (since providing full-time care to a person with major activity limitations can be enormously taxing, both physically and emotionally),” she said.

Engelman said that in cases when relocation isn't practical for either the parent or a child, other care options - like hiring a home-health aide or moving to a skilled nursing facility - become more important.

SOURCE: http://bit.ly/1zanbcA Journals of Gerontology, Series B, online June 18, 2014.

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