Neuropsychiatric index and relationship quality for caregivers of older Mexican Americans

Abstract

AbstractBackgroundInformal caregivers play a key role in supporting older Mexican Americans, as they are less likely to enter nursing facilities than other racial/ethnic groups in the U.S, even when faced with high levels of physical and cognitive impairment. The quality of caregiving relationships is directly related to caregiver stress. However, there is little research on the correlates of caregiver assessment of relationship quality. Assessment of caregiver relationship quality is especially important for Mexican American older adult caregivers due to the high prevalence of cognitive impairment and dementia in this population.MethodsUsing data from caregiver supplement of the wave 7 of the Hispanic Established Population for the Epidemiologic Study of Elderly (HEPESE)(n=460) study of very old (Age 85+) Mexican Americans we examine the association of relationship quality with care recipient health, caregiver health, and caregiver finances. Caregiver relationship quality is measured using both positive and negative relationship assessments separately. We use linear regression to examine the correlates of caregiver relationship quality net of caregiver and care recipient demographics, care recipient physical (caregiver‐rated health, ADL and IADL disability) and mental health (caregiver‐rated NPI and care recipient MMSE), caregiver health (caregiver‐rated health and depression) caregiver finances (income and financial burden).ResultsCaregivers who were married to the care recipient reported both less positive and more negative assessments. Male care recipients, married caregivers, and caregiver depression were related to positive but not negative assessments. Both positive and negative assessments were significantly associated with IADL disability and NPI score but not MMSE score.ConclusionsRelationship quality for Mexican Americans among the very old is related to hands‐on care tasks and not financial strain. Disability status suggests that early changes in functional status are more stressful than more severe disability due to adjustment periods. Married caregivers may report higher relationship quality due to additional support from spouses in caregiving roles. NPI status is the most strongly associated correlate of both positive and negative relationship quality, while MMSE was not significantly related to either. Our results suggest that caregiver assessments of behavioral disturbances are more important to relationship quality than care recipient tested cognitive functioning.