As the American population ages, policymakers must address a rapid expansion of demand for long-term care services to support older adults with functional limitations. Long-term care describes resources designed to compensate for functional disabilities and keep an older adult healthy and safe for an extended period. Most American long-term care is provided informally by family members, and most Americans express a preference to receive this care in a community setting rather than in an institution. Given that long-term care is resource intensive, it often requires relocation. About 20 percent of older adults co-reside with their informal caregiver in a shared household to receive long-term care. This dissertation examines drivers of and barriers to relocation between community environments, and particularly the facilitators of co-residence for long-term care support. Using a model of healthcare access, findings demonstrate three drivers of co-residence. Community health describes the physical capacity for younger adults to provide care. The second chapter of the dissertation observes changes in older adult household structure in communities with high opioid use. Individual economic resources impact relocation and co-residence decisions. The third dissertation chapter demonstrates a contraction of co-residence with macro-economic recession and recommends housing market changes as a possible mechanism driving this relationship between the macro economy and older adult household structures. Finally, paid services will also change older adult household structures, as the fourth chapter demonstrates with an examination of Medicare home health services substituting for informal co-resident caregiving. The decision to relocate and the decision to co-reside each bear specific economic and health implications, and long-term care policy must consider both the advantages of disadvantages of policies that rely on relocation to access informal co-resident care to accomplish the long-term personal care of Americas aging population.