Caregiving across distances: residential proximity, care activities, and mental health

Adult children increasingly provide care to parents from varying distances, yet the relationship between proximity and caregiver mental health is not well understood. This study characterizes caregiving activities of adult-child caregivers based on residential proximity to their parent and examines associations with depression and anxiety symptoms.

Data from the 2021 National Health and Aging Trends Study Round 11 was linked with National Study of Caregiving IV. The sample included adult-child caregivers of Medicare beneficiaries aged 71 and older. Bivariate and multivariable logistic regression models assessed associations between proximity (travel time between the caregivers and their parents), caregiving activities, and symptoms of depression and anxiety. Analyses were weighted to produce nationally representative estimates.

Among 932 caregivers representing more than 9 million caregivers nationwide, 26.3% co-reside with care-recipients, 47.4% live 1-20 min away, 13.1% live 21-59 min away, and 13.2% are long-distance caregivers living ≥1 hr away. Co-residing caregivers were more likely to perform health management, health care, Activities of Daily Living, and Instrumental Activities of Daily Living tasks. However, proximity was not associated with differences in health system logistics, patient advocacy, and financial support activities. Proximity did not predict of depression or anxiety in adjusted models.

Adult children engage in diverse caregiving activities regardless of distance, especially in logistics, advocacy, and financial support. Factors beyond proximity likely influence caregiver mental health. Findings highlight the need for tailored policies and services supporting both distance and proximal caregivers of older adults.