Mexican American Caregivers Research Articles

Outcomes Among Mexican American and Non-Hispanic White Informal Stroke Caregivers.

Informal home care is prevalent among Mexican American stroke survivors, but data on the impact on caregivers are not available. The aim was to assess ethnic differences in informal stroke caregiving and caregiver outcomes at 90 days poststroke. Informal caregivers were recruited from the population-based Brain Attack Surveillance in Corpus Christi Project (2019-2023), conducted in a bi-ethnic community in Texas. Caregivers of community-dwelling stroke survivors who were not cognitively impaired and not employed by a formal caregiving agency were interviewed. Interviews included sociodemographics, dyad characteristics, Modified Caregiver Strain Index (range 0-26, higher more positive), Positive Aspects of Caregiving scale (range, 5-45, higher more), Patient Health Questionnaire-8 (range, 0-30, higher worse), and PROMIS (Patient-Reported Outcomes Measurement Information System)-10 physical (range, 16.2-67.7, higher better) and mental health (range, 21.2-67.6, higher better) summary scores. Stroke survivor data was from interviews and medical records. Propensity score methods were used to balance caregiver and patient factors among Mexican American and Non-Hispanic White caregivers by fitting a model with ethnicity of caregiver as the outcome and predictors being caregiver sociodemographics, patient-caregiver dyad characteristics, and patient sociodemographics and functional disability. Propensity scores were included as a covariate in regression models, considering the association between ethnicity and outcomes. Mexican American caregivers were younger, more likely female, and more likely a child of the stroke survivor than Non-Hispanic White caregivers. Mexican American caregiver ethnicity was associated with less caregiver strain (β, -1.87 [95% CI, -3.51 to -0.22]) and depressive symptoms (β, -2.02 [95% CI, -3.41 to -0.64]) and more favorable mental health (β, 4.90 [95% CI, 2.49-7.31]) and positive aspects of caregiving (β, 3.29 [95% CI, 1.35-5.23]) but not associated with physical health. Understanding the mechanisms behind more favorable caregiver outcomes in Mexican American people may aid in the design of culturally sensitive interventions to improve both caregiver and stroke survivor outcomes, potentially across all race and ethnic groups.

Abstract TP73: Outcomes in Mexican American Informal Stroke Caregivers and Differences by Ethnicity

Background: Informal home care is the most prevalent type of post-acute care (PAC) in Mexican American (MA) stroke survivors, but data on the impact on caregivers is not available. The objective was to investigate strain, positive aspects of caregiving, familial obligations/support, and depression in stroke caregivers and ethnic differences in a population-based study. Methods: Data are from Brain Attack Surveillance in Corpus Christi PAC Study. Community-dwelling stroke survivors and their caregivers were recruited (n=307). Caregiver eligibility included: 1) residence in study county, 2) not cognitively impaired, 3) not providing care pre-stroke. Caregiver interviews at ~90 days included sociodemographics, dyad characteristics, Modified Caregiver Strain Index (MCSI range 0-26, higher more), PAC scale by Tarlow et al (range 5-45, higher more), familial obligations/support scales by Sabogal et al (range 1-5, higher greater), and PHQ-8 (range 0-30, higher worse). Patient data were from interviews and medical records. Propensity score (PS) methods were used to balance caregiver and patient factors among MA and non-Hispanic white (NHW) caregivers by fitting a model with ethnicity of caregiver as the outcome and predictors being caregiver sociodemographics, patient-caregiver dyad characteristics, and patient sociodemographics and disability. PS were then included as a covariate in regression models considering the association between ethnicity and outcomes. Results: MA caregivers were younger, more likely female, and more likely a child than NHWs. Median MCSI, PAC scale, PHQ-8 were 11 (IQR:6-17), 36 (IQR:30-40), and 11 (IQR:9-15) in MAs and 13.5 (IQR:9-18.3), 30 (IQR:25-36.3) and 13 (IQR:10-16) in NHWS. MA ethnicity was associated with less caregiver strain (β=-2.22, 95% CI:-4.19, -0.26) and depression (β=-2.05, 95% CI:-3.48, -0.63) and more positive aspects of caregiving (β=2.96, 95% CI:0.91, 5.01), but not associated with familial obligations/support. Conclusions: Informal stroke caregivers report moderate levels of strain and depressive symptoms, with NHW caregivers reporting higher levels. MA caregivers report greater positive aspects of caregiving suggesting a possible intervention target to improve outcomes in MAs.

THE FINANCIAL AND EMOTIONAL IMPACT OF COVID-19 FOR DEMENTIA CAREGIVERS: A COMPARISON OF THE NHATS AND HISPANIC EPESE

Abstract During the COVID-19 pandemic, older adults and their caregivers/care partners (hereafter referred to as “caregivers”) experienced social isolation, reduced autonomy, disruptions in medical care and barriers to community-based services such as adult day centers. We compare the extent to which these disruptions affected white, Black, and Hispanic caregivers. We utilize newly released data on adult children caregivers from the Caregiver Supplement to the Hispanic Establish Population for the Epidemiologic Study of the Elderly (HEPESE CG, 2021) and the National Health and Aging Trends COVID-19 Family Members and Friends Dataset (NHATS FF, 2020/2021) to compare caregiver emotional well-being and financial strain among non-Hispanic White (NH White, n=327), non-Hispanic Black (NH Black, n=57), and Mexican American (n=57) adult children caregivers. Results reveal that a larger fraction of NH Black and Mexican American caregivers reported financial strain than NH White caregivers, and that more Mexican American caregivers reported loneliness and depression than other groups of caregivers. For Mexican American caregivers, those reporting lower financial well-being tended to be younger. For NH Black caregivers, there were no significant predictors of financial strain or wellbeing. Finally, NH White caregivers were younger, and more likely to be female and NH White dementia caregivers reported more financial strain and loneliness than NH White non-dementia caregivers. Taken together, this work provides valuable insight into the role of the COVID-19 pandemic in exacerbating caregiver health disparities among caregivers and provides valuable insight as well as to the high-impact intervention points for caregivers from minoritized populations.

RELATIONSHIPS BETWEEN DISTRESS AND NEIGHBORHOOD CHARACTERISTICS FOR MEXICAN AMERICAN CAREGIVERS

Abstract Previous study demonstrates that caring for older relatives with physical or cognitive disability can increase caregiver stress—particularly if neuropsychiatric symptoms are present. The literature suggests that community features such as the percentage of immigrants may improve Mexican-American caregivers’ mental health. Using matched 2011/2012 data on caregivers and care recipients from the Hispanic Established Population for the Epidemiological Study of the Elderly(H-EPESE) and the 2010 census tract characteristics from the National Neighborhood Data Archive (NANDA) recently, we fit multilevel regression models to assess how neighborhood characteristics (census tract proportion Latino, proportion foreign-born, and proportion in poverty) affect caregiver distress (caregiver depression score, caregiver general stress, caregiver reports of neuropsychiatric behavioral symptoms of cognitive decline and caregiver report of stress from neuropsychiatric behavioral symptoms of cognitive decline). We found that living in an area with a higher proportion of foreign-born adults is related to lower reports of neuropsychiatric symptoms and lower levels of caregiver distress. Family caregivers residing in ethnic enclaves with high proportions of foreign-born persons reported significantly fewer symptoms of feeling stubborn and resistive, being in low spirits, feeling upset when separated from the care recipient, losing interest in usual activities, or experiencing changes in weight. While residing in these communities may reduce behavioral concerns in care recipients and increase social support availability, cultural factors such as ideas about normative aging may influence symptom reporting. Increasing available support for caregivers residing in ethnic enclaves is an important step toward developing dementia-capable communities and reducing caregiver health disparities.

Neuropsychiatric symptoms are Predictors of Disturbed Sleep in Mexican American Caregivers

AbstractBackgroundCaregivers of people living with dementia are more likely to experience disturbed sleep compared to non‐caregivers. Mexican‐Americans may be especially at risk due to low rates of nursing home use even in advanced dementia, when behavioral symptoms are most apparent. Few studies have evaluated predictors of disturbed sleep in this high‐risk group.MethodUsing data from the 2015 wave of the Hispanic Established Population for Epidemiologic Study of the Elderly, a representative sample of older Mexican‐Americans and their caregivers in the southwestern United States (n = 460), we examined the association of care recipient neuropsychiatric symptoms with disturbed sleep in caregivers. Care recipients’ behavioral symptoms of cognitive decline were assessed using the caregiver‐reported Neuropsychiatric Inventory. We examined caregivers’ depressive symptoms as an additional stressor. Potential “buffers” against sleep disturbances included communal support (neighbor, church, social services) and respite care. Caregivers were classified as having “highly disturbed sleep” if they reported disturbed sleep three or more days a week, and were compared to caregivers with “non‐highly disturbed sleep” (reported disturbed sleep less than three days a week). We used multivariable logistic regression to examine the association between behavioral symptoms and highly disturbed sleep, controlling for demographic factors and care buffers.ResultCaregivers in the sample were predominantly spouses or adult children of their care recipients. They had a mean age of 59.7 and7 8% were women. Care recipients were a mean age of 90 and 65% were women. Caregivers with disturbed sleep (12% of the sample) reported significantly more care recipient NPI symptoms, distress from symptoms, and more depressive symptoms. In the regression model accounting for all predictors, the number of NPI symptoms and depressive symptoms were associated with higher odds of disturbed sleep, while communal support was associated with lower odds of disturbed sleep. Use of respite care did not show associations.ConclusionBehavioral symptoms of cognitive impairment are associated with sleep disturbance in Mexican American caregivers. Though respite has been described as a crucial resource for caregiver sleep health, communal supports were more significantly associated with sleep l. These results should inform the development of culturally‐competent resources for Mexican‐Americans.

MEXICAN AMERICAN CAREGIVER HEALTH AND TURNOVER: THE ROLE OF STRESSORS, RESOURCES, AND BACKGROUND FACTORS

Abstract The purpose of this study is to explore the role of caregiver background, stressors, and resources for Mexican American caregiver turnover and depressive symptoms. Using two waves of the Hispanic Established Epidemiologic Study of the Elderly Caregiver Supplement (H-EPESE CG, 2010/2011-2016 N=333) and informed by the sociocultural caregiver stress process model, we estimate logistic and OLS regressions of caregiver turnover and caregiver depressive symptoms over five years. Neuropsychiatric expressions of dementia were significantly associated with caregiver turnover and relative to caregivers who were adult children of the care recipient, grandchildren caregivers and other kin and non-kin caregivers were more likely to experience caregiver turnover. While depressive symptoms were relatively low at both waves, there was a greater increase in depressive symptoms for caregivers who completed the interview in Spanish, which was partially explained by lower caregiver resources (e.g., support from others). The findings demonstrate the need for dementia care supports for Mexican American caregivers, improving support systems for Spanish-speaking caregivers, and supporting Mexican American caregivers who may be entering the role unexpectedly (e.g., grandchildren or non-kin).

TURNOVER AND DEPRESSIVE SYMPTOMS AMONG MEXICAN AMERICAN CAREGIVERS OF PERSONS LIVING WITH DEMENTIA

Abstract This study explored the role of caregiver background, stressors, and resources for Mexican American caregiver turnover and depressive symptoms. Using two waves of the Hispanic Established Epidemiologic Study of the Elderly (H-EPESE, 2010/2011-2016 N=333) Caregiver Supplement and informed by the sociocultural caregiver stress process model, we estimate logistic and OLS regressions of change in dementia and change in caregiver over five years. Neuropsychiatric expressions were significantly associated with caregiver turnover. Adult children and grandchildren caregivers were more likely to experience caregiver turnover than spouses. While depressive symptoms were relatively low at both waves, there was a greater increase in depressive symptoms occurred for caregivers who completed the interview in Spanish rather than English, which was partially explained by greater perceived stress at baseline. Findings demonstrate the need to provide dementia care supports for Mexican American caregivers, reduce stress for Spanish-speaking caregivers, and support Mexican American grandchildren who unexpectedly become caregivers.

CAREGIVING NETWORKS OF DIVERSE FAMILIES: CONTEXT AND CULTURE INFLUENCES ON DEMENTIA CARE

Abstract Older adults living with dementia and their primary caregivers are embedded within larger family and formal care networks that are shaped by cultural and contextual influences. Yet information about diverse caregiving networks is sparse. This symposium focuses on the composition, structure, responsibilities, and influences of caregiving networks in supporting persons living with dementia and their primary family caregivers. Savla and colleagues identify six distinct care networks among dementia family caregivers living in economically diverse areas of rural Appalachia. Networks varied by caregivers’ emotional connectivity with family/friends, caregiver strain, role overload, loneliness, and service attitudes and utilization. Ashida and colleagues focus on changes in rural and urban dementia family caregiving networks during the COVID-19 pandemic. Network members engaging in negative social interactions increased while those engaging in uplifting interactions decreased over time, especially among urban caregivers. Bonds Johnson and colleagues examine shared decision making between African American caregivers and their relative living with dementia. Dyadic analysis revealed that while care recipients were involved in the decision-making processes, their care network’s level of the involvement varied. Angel and colleagues explore the role of caregiver characteristics, stressors, and resources for Mexican American caregivers. Depressive symptoms were significantly associated with dementia caregiver turnover, with adult children and grandchildren caregivers more likely to experience turnover than spouses. Collectively, the findings presented extend prior research on community-based dementia caregiving, broadening the focus from a single caregiver to a network of caregivers and capturing the complexities of place-based context and culture variations in care provision.

Screen-related discord and dismay in low-income Mexican American families with toddlers: A qualitative study

PurposeUnderstanding parental experiences with managing their toddler's screen use is important to inform the design of interventions addressing early childhood screen use, yet current evidence is limited. To enhance our understanding of the context of toddler screen use, this study characterizes the screen-related discord and dismay parents experience in families with toddlers. Design and methodsIn-depth interviews were conducted to explore everyday experiences with screen use among low-income Mexican American caregivers of toddlers (21 mothers, 10 fathers, 1 grandmother). Transcripts were content analyzed to identify prominent themes. ResultsThree themes were identified. Experiences of screen-related discord and dismay arose (1) between parent and child, (2) between parents, and (3) surfaced as parental internal dissonance about toddler screen use. Parent-child discord resulted from parental limit setting and child reactions to parental screen use, which often included tantrums. Parent-partner discord included patterns of agreeing to disagree and direct disagreement between partners. Parents also reported their own feelings of ambivalence and dismay as they struggled to reconcile their preferences against their toddler's actual screen use, while living in a screen-saturated world. ConclusionsFindings offer insight into types of screen-related discord and dismay low-income Mexican American parents experience as they attempt to manage their toddler's screen use. Practice implicationsAlthough discord in families is normal, the screen-specific discord reported by participants warrants consideration in efforts promoting healthy screen use in families. Providers can tailor their counseling to consider the range of screen-related discord families of toddlers may experience.

Mexican–American caregivers' perceptions of a culturally adapted transition planning program for youth with autism

AbstractThe transition from adolescence to adulthood is difficult for individuals with autism spectrum disorder (ASD) and their families because they must learn to navigate the complex adult disability service delivery system. For Latinx (vs. White) families of youth with ASD, this period is especially difficult because of the systemic barriers (e.g., language and cultural differences) they face when accessing services. To support Latinx families, effective and culturally responsive supports (e.g. culturally tailored programs) are critical. To this end, the purpose of this study is to describe the cultural adaptation of a transition planning program (i.e., ASSIST) for Latinx families of youth with ASD. First, we culturally adapted the curriculum using the Ecological Validity Framework (Bernal et al., 1995) and the Cultural Sensitivity (CS) model (Resnicow et al., 1999). Then, we presented the culturally adapted curriculum to eight Mexican–American caregivers of youth with ASD. Specifically, we conducted three individual interviews with each participant (N = 24 interviews altogether) to examine their perceptions of the six sessions of the culturally adapted curriculum. Based on their feedback, changes were made to the curriculum. Overall, participants reported positive perceptions of the culturally adapted curriculum, but suggested the following recommendations: include information related to mixed‐status families, add information about guardianship, and use the translation technique of borrowing for specific terms. Based on the findings, implications for research and practice are discussed.

Neuropsychiatric symptoms and caregiver relationship quality for older Mexican Americans

Objectives Caregivers play a key role in supporting older Mexican Americans, who are less likely to enter nursing facilities than other racial/ethnic groups in the US. However, there is little research on how Neuropsychiatric symptoms (NPS) affect relationship quality between caregivers and care recipients. Method Using data from the 2015 wave of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (n = 416) study of older (age 85+) Mexican Americans, we examined relationship quality and NPS with ordered logistic regression. Relationship quality was measured using positive (enjoyment, appreciation) and negative (nerves, argue) assessments. NPS were categorized into hyperactivity, affective, and psychosis symptoms. Results Hyperactivity symptoms were associated with appreciation, arguing, and nerves. Psychosis symptoms were associated with arguing and nerves. Spousal caregivers were more likely to report arguing and nerves and less likely to report feeling appreciated. Enjoyment assessments were not associated with NPS. Conclusion Relationship quality is related to behavioral changes in late life. Mexican American caregivers negatively evaluate their relationships, not in response to care tasks per se, but when the older person exhibits behavioral problems. The relationship between NPS and negative relationship assessments may be due to unanticipated behavior changes in late life and stigma around psychiatric symptomatology.

Culturally Sensitive Care: Enlisting Community Partners to Meet Mexican American Caregiver Needs.

Culturally sensitive interventions are needed to assist Mexican American (MA) patients with cancer and their family members in managing their care, navigating the healthcare system, and decreasing disparities in healthcare outcomes for Hispanics with cancer. The objectives of this study were to understand the meaning of culturally sensitive care for oncology clinic healthcare providers and to assess the usefulness and feasibility of the role of a promotora de salud to meet caregiver needs. This study involved focus groups of 18 diverse providers who provided data for qualitative analyses. The findings (themes) defined the facilitators of and barriers to culturally sensitive care and the perceived role of a promotora de salud to support the healthcare team and improve cancer care provided by MA caregivers. In addition, promotoras de salud can help reduce health costs by decreasing patient clinic visits.

The "Reckoning Point" as a Marker for Formal Palliative and End-of-Life Care in Mexican American Families.

Palliative and end-of-life care (PEOLC) in Mexican American (MA) caregiving families remains unexplored. Its onset was uncovered in our mixed methods, multisite, interdisciplinary, qualitative descriptive study of 116 caregivers, most of whom had provided long-term informal home care for chronically ill, disabled older family members. This subanalysis used Life Course Perspective to examine the "point of reckoning" in these families, where an older person is taken in for care, or care escalates until one recognizes oneself as the primary caregiver. Ninety-three of 116 caregivers recognized and spontaneously reported a "reckoning point" that initiated the caregiving trajectory, while eight cited "gradual decline" into caregiving for elders in their homes. This "reckoning point," which marks the assumption of this role, may afford a fertile opportunity for referral to community resources or initiation of formal PEOLC, thereby improving the quality of life for these older individuals and their families.

Collective Care: Multiple Caregivers and Multiple Care Recipients in Mexican American Families.

Specific stressors associated with caregiving in Mexican American (MA) families are not well documented, yet caregiving issues are paramount because informal care for parents is central to their culture. Although MA families who band together to provide care for one member are not unique, the literature does not describe the phenomenon of collective caregiving, which may be widespread but unrecognized. This article describes these understudied families who are poorly served by contemporary health systems because their characteristics are unknown. Descriptive, multisite, longitudinal mixed-methods study of MA caregiving families. We identified three types of collective caregivers: those providing care for multiple family members simultaneously, those providing care successively to several family members, and/or those needing care themselves during their caregiving of others. Collective caregiving of MA elders warrants further investigation. Exploration of collective caregiving may provide a foundation for tailored family interventions.

The Life Course Perspective: a Guide for Genetic Counselors.

This is the first article in a two part series about utilizing the life course perspective (LCP) in genetic counseling. LCP can be a useful tool for genetic counselors when counseling people with a known genetic mutation. Previous theories such as Protection Motivation Theory (PMT) and Common Sense Model of Self-Regulation (CSMSR) examine current reactions to a positive genetic test result. LCP extends beyond the current time to explore temporal and contextual elements of the experience. A review of research revealed, LCP has been used to study the perspective of caregivers of people with Alzheimer's disease, referral for a family history of breast cancer, Mexican American caregivers of older adult, social class and cancer incidence and cancer and the sense of mastery. Incorporating LCP into a study explaining the experiences of people living with a positive test result for a genetic mutation such as the BRCA mutation provides a comprehensive exploration of this experience.

Mexican-American caregivers’ perceptions about asthma management: a photovoice study

Objective: The purpose of this study is to report how photovoice was used to (1) ascertain Mexican-American caregiver perspectives about asthma management, and (2) engage caregivers in dissemination. Methods: Eleven Mexican-American caregivers of children with asthma were recruited and given cameras to photograph what helped or hindered their ability to care for their child. Participants prioritized which images to share, discussed the images with the group, and wrote accompanying titles and captions in four photovoice sessions. Sessions were in Spanish and occurred in a community setting. Participants presented their work to peers and community members. Identified issues were subsequently categorized by investigators according to the four components of asthma care. Results: Participants prioritized 32 phototexts, the majority of which (n = 20, 63%) reflected activities associated with environmental control. Caregivers highlighted asthma triggers, and suggested ways to maintain indoor air quality (IAQ) through home cleaning. The need for policies that enforce smoking bans in shared housing and public places was identified as an important strategy to improve outdoor air quality. “Education for a Partnership in Asthma Care” was represented in six (19%) phototexts. Five phototexts (16%) represented “Assessment and Monitoring”. Only one phototext (3.13%) primarily represented “Medications”. Conclusions: Results support the need for active partnerships between caregivers and providers. Photographs can serve as the basis for reciprocal education between patient and provider, especially in the area of environmental triggers. Provider visits should include assessment, strategies and resources to maximize IAQ. Photovoice facilitates caregivers’ ability to advocate for improved asthma management and health equity.

Worry Among Mexican American Caregivers of Community-Dwelling Elders.

This mixed methods, multi-site, National Institute of Nursing Research (NINR)-funded, interdisciplinary, descriptive study aimed to identify expressions of worry in qualitative data obtained from caregiving Mexican American (MA) families assisting older adults. The purpose of this portion of the inquiry was to determine how worry is expressed, what happens to caregivers when they worry, and what adaptive strategies they used. We examined semi-structured interviews completed during six in-home visits with 116 caregivers. We identified 366 worry quotations from 639 primary documents in ATLAS.ti, entered them into matrices, and organized findings under thematic statements. Caregivers expressed cultural and contextual worries, worried about transitions and turning points in care, and identified adaptive strategies. Despite these strategies, worry persisted. Constant worry may be an allied, important aspect of caregiver burden. We need additional longitudinal research to better understand the experience of MA caregivers for older adults and to provide empirically supported interventions, programs, and services that reduce worry.

Family routines within the ecological niche: an analysis of the psychological well-being of U.S. caregivers of children with disabilities.

Using mixed methods, this study examined the relationship of caregivers of children with disabilities’ psychological well-being (PWB) and their orchestration of daily routines within their ecological niche. Thirty-nine U.S. caregivers completed in-depth interviews, PWB Scales, and Family Time and Routines Index (FTRI). We used a multi-step analysis. Interview data was coded and vignettes created without knowledge of PWB and FTRI ratings. Next, the relationship of quantitative measures was analyzed. Four groups were created using FTRI-extent and PWB means: (1) low routine-low PWB, (2) low routine-high PWB, (3) high routine-low PWB, and (4) high routine-high PWB. We examined qualitative differences in key features between groups. Findings: Total PWB and FTRI scores were not significantly correlated, PWB Purpose in Life and FTRI-extent scores were moderately positively correlated, and PWB Environmental Mastery and FTRI-extent correlation approached significance. Qualitative findings describe caregivers’ structuring of routines, intensity of oversight, support in routines, management of dinner, paid work, and needs for respite. The four groups differed in paid work, household support, degree the child could self-occupy, Environmental Mastery, and opportunities to recuperate. Caregivers with higher levels of well-being and more regular routines did paid work, had supportive spouses, had children who more often could follow routines, had higher Environmental Mastery, could orchestrate a family meal, and had breaks from care in either work or leisure. All Native American caregivers and Mexican American caregivers with spouses were in the high routine-high PWB group. Insight into this complex negotiation between family members within daily routines may provide practitioners a better understanding of how to work within family circles to foster therapeutic alliances, identify focused intervention targets, and promote positive family wide outcomes.

Is Religiosity a Protective Factor for Mexican-American Filial Caregivers?

Using interview data collected from 47 Mexican-American families, this study explored whether two measures of religiosity—prayer and/or meditation, and participation in religious services—predicted caregiving outcomes in filial caregivers. Dependent variables included the perceived benefits derived from caregiving, and the subjective appraisal of caregiving as burdensome. Treated as covariates were caregiver age and income, care receiver co-residence, cultural orientation, the care receiver’s functional impairment, restrictions on the caregiver’s social activities, and the caregiver’s sense of mastery and competence in caregiving. Use of prayer and/or meditation was predictive of the perception that caregiving resulted in perceived benefits, and participating in religious services/meetings/activities was predictive of lower levels of subjective burden.

Activities of Daily Living in Mexican American Caregivers

La familia drives elder care in Mexican-American (MA) families, but nursing home placement can result from day-to-day caregiving demands that increase caregiver difficulty with activities of daily living (ADLs). Using life course perspective, this article describes the initial data wave of 31 MA caregivers from a descriptive, longitudinal, mixed-methods study of 110 MA caregivers and care recipients over 15 months in their caregiving trajectories. Fifteen of 31 caregivers consistently indicated "no help needed" on the Katz ADL, whereas all but one reported "help needed" during semistructured interviews with cultural brokers. In addition to the discrepancy between results on the Katz ADL and interviews, findings include consideration of nursing home placement by moderately acculturated caregivers and minimization of their illnesses by caregivers. Additional methods of MA caregiver assessment may be needed due to the questionable accuracy of the Katz ADL; additional research should explore minimization and acculturation in MA caregivers.