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Race, Ethnicity, Culture

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Those older than 65 will increase to 20% by 2050 ... Research on Race, Ethnicity ... needs and reliance on spirituality (e.g. 'meaning based coping') vary by race. ... – PowerPoint PPT presentation

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Title: Race, Ethnicity, Culture


1
Race, Ethnicity, Culture
  • And beyond the Primary Caregiver

2
The Need to Understand Racial and Cultural
Differences in Caregiving
3
Population Changes
  • Those older than 65 will increase to 20 by 2050
  • Elderly White population will double 2000 2050
    (X 2)
  • African American will quadruple (X 4)
  • Hispanic increase by ( X7)
  • Native Americans (X 3.5) and Pacific Islanders (X
    6.5)

4
Research on Race, Ethnicity
  • Relatively few studies have compared the
    experience of caregiving across racial, ethnic or
    cultural lines.
  • Mostly we know about more objective differences.

5
Problems in the research
6
Sampling
  • Small, non-representative samples are the norm.
  • Why is use of convenience samples a problem?
  • Samples recruited through community orgs,
    Alzheimers associations, social and health
    service orgs., advertisements, radio, hospitals,
    etc. means it is difficult to determine the
    population represented by these samples.
  • The sample may be biased in some unknown way.

7
Some Well-Documented Differences
  • Rates of institutionalization for minority elders
    lower than for White elders
  • Prevalence of severe functional limitations
    higher among minority seniors living at home than
    White elders
  • AA and Hispanic Americans use fewer formal
    services, but report need for more assistance

8
One study
  • Navaie-Waliser, Feldman, Fould, Levine, Kuerbis
    Donelan 2001
  • Random digit dialing identified 4991 family
    households in NYC
  • After screening, 402 individuals who met
    eligibility agreed to participate.
  • Complete data on 397

9
Sample
  • White, non Hispanic 164
  • Black, non Hispanic 129
  • Hispanic 87
  • Other 17
  • 17 overall prevalence of caregiving

10
Results
  • White caregivers and care receivers were older
    (71 vs. 65 for recipient).
  • gt70 of all cg had no help from formal
  • gt80 providing care for more than 1 yr.
  • Black cg more likely to be providing higher
    intensity care (e.g. dressing, feeding,
    transferring)

11
Black Caregivers
  • Report heavier workload and more unmet needs.
  • But, less likely to report difficulty providing
    care
  • More likely to experience increased religiosity
    since becoming a caregiver

12
Hispanic Caregivers
  • More likely to have unmet needs than White
    caregivers
  • More likely to receive help from paid caregivers
    than White
  • Also, more likely to experience increased
    religiosity since becoming caregiver than White

13
Overall
  • Higher intensity care associated with greater
    unmet needs
  • Caregivers providing higher intensity care were
    more likely to receive formal, paid help
  • Increased religiosity associated with greater
    unmet needs and higher intensity care

14
Overall Finding
  • Caregiving workload, reported difficulty in care
    provision, having unmet needs and reliance on
    spirituality (e.g. meaning based coping) vary
    by race.

15
Beyond Primary Caregivers
  • Most research has focused on a single individual
    identified as the primary caregiver but what
    happens if we look at the network of family
    members who provide care over time. How stable
    is it and how much change occurs?

16
Longitudinal Study
  • Szinovacz and Davey, 2007
  • Used waves 1 through 5 (1992 -2000) of a national
    survey that looked at adult children caring for
    one or more parents.

17
Results
  • Change in adult child caregivers occurred in 54
    of cases.
  • gt 25 of primary adult child caregivers were
    replaced by a sibling
  • 33 of all networks added at least one adult
    child
  • 34.5 dropped at least one adult child.

18
Systems of Support
  • Williams and Dilworth-Anderson, 2002
  • 187 African American caregivers looked at use of
    formal, church and informal support.
  • Higher education associated with use of formal
    support
  • Greater dependency in care receiver, more
    behavioral problems associated with less use of
    formal services

19
  • (Note did not look at effect of cognition..
    Presence of dementia as a predictor as did Birkel
    Canon)
  • Higher levels of informal support and network
    density were associated with lower use of formal
    services.
  • (Which may point to insularity)

20
Linking
  • More dense networks (cohesive) did not link to
    formal services.
  • Larger networks did link to formal services.
  • Church membership did link to formal supports.

21
Networks
Low Density
22
Networks
High Density
23
Networks
Insularity
High Density
24
Networks
25
Networks
26
Networks
Linking Function
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