Understanding the racial and ethnic differences in caregiving arrangements

In this study, the relative importance of family/household structure, socioeconomic status, and culture is examined, and their connection to racial and ethnic variations in caregiving networks is explored. Each of these three domains is seen as contributing to the race/ethnic variations in caregiving arrangements.     

A Challenge to Critical Understandings of Race

In this article, I demonstrate fundamental weaknesses in the ability of critical understandings of race to produce reliable knowledge of how social actors use social comparisons as a way to align self with ingroup. I trace these weaknesses to two sources: The first is relying on social status as an explanation for race‐based assessments, ingroup motivations, and social constructions of otherness. This is opposed to leaning on assessments grounded in social psychological research that links properties of human cognition to the development and maintenance of social identities. The second weakness is an open support for activist research that is often situated in radical multiculturalism. Because critical race scholars openly side with racial minorities’ interests, they tend to establish incomplete assessments of social behaviors and social constructs linked to racial identities in order to maintain their stated political allegiances. To demonstrate these and other weaknesses, I draw upon the theoretical insights of social identity theory which is used to reassess Bell and Hartmann's (2007) critical race analysis of diversity dialogue in American society.     

Effects of Nurturing and Non‐nurturing Caregiving on Child Social Initiatives: An Experimental Investigation of Emotion as a Mediator of Social Behavior1

This study examined the effects of one unfamiliar adult's warm, responsive interactions or cold, aloof, unresponsive interactions on child emotion and subsequent social initiatives to a second adult. Participants were 32 4¹/₂‐ to 5¹/₂‐year‐old preschool children. Nurturing, responsive caregiving and non‐nurturing, unresponsive caregiving were experimentally manipulated by experimenter facial and vocal affective expressions, positive versus negative statements to the child, and contingency of responding to the child's behavior. The effect of nurturance was examined on child emotions and social initiatives to another adult. Non‐nurturing caregiving produced less expressed happiness and fewer subsequent social initiatives. Furthermore, child emotion was found to mediate partially the relation between nurturing caregiving and social initiatives, with children who experienced interactions with a non‐nurturing caregiver expressing less happiness, which led to decreased social initiatives to a second adult.     

The United States should recognize and support caregiving youth

In the United States, more than 5.4 million children and adolescents under age 18 provide care for family members who are aging or have chronic illness, disability, or other health conditions that require assistance. In this policy report, we describe youth’s care for the family, and highlight the increasing prevalence, global challenges, and uneven successes of measurement and categorization. We briefly summarize research on how caregiving affects youth’s academic, social, and emotional well-being. Next, we present novel, emerging evidence from the public school-based 2019 Youth Risk Behavior Survey for the State of Florida, which suggests that as many as 24% of middle school students and 16% of high school students provide at least some care to the family on a regular basis. Drawing on this evidence, we discuss targeted social programs which have been shown to promote the well-being of caregiving youth outside of the United States, as well as a 13-year-old school-based intervention in The School District of Palm Beach County, Florida. We conclude with specific recommendations for a path toward recognizing and supporting caregiving youth via policy and practice in the United States. Our aim is to increase the awareness and feasibility of identifying and supporting caregiving youth and their families via government-organized data collection and targeted social policies.     

Predicting Future Commitment to Care for Frail Parents Among Employed Caregivers

A study of 133 full time employees with parent care responsibilities investigated various factors that could reduce this group's future caregiving commitment to aging parents. Study factors included: caregiver attributes, level of caregiving involvement, job stress, tensions between the caregiver and the dependent parent, caregiver's level of physical and mental strain, and limited support from family and friends. The relationship between the caregiver and the parent was the best predictor of sustained commitment to caregiving. One aspect of the employees' work experience made a small, but important contribution to respondents' future care plans. Those employees who frequently adjusted their work schedule and routine to accommodate parent care demands were less likely to sustain their caregiving commitment. Reasons for these findings are explored and implications for social policy and clinical practice are discussed.     

Dementia Caregiving Outcomes: The Impact of Caregiving Onset,Cognitive Impairment and Behavioral Problems

With a projected increase in the prevalence of Alzheimer’s disease (AD) and related dementias, family caregiving is steadily increasing. Caring for an individual with AD is characterized as a “career,” and within this career are a number of key transitions, including the onset of caregiving. Research reveals a number of negative emotional health outcomes for AD caregivers, including depression and role overload, but less research has examined the influence of key transitions on the emotional adaptation of caregivers. The purpose of this study is to examine how different patterns of caregiving onset (gradual and abrupt) impact emotional health outcomes for AD caregivers. This study also explores how care-recipient cognitive impairment and behavioral problems moderate these relationships. Cross-sectional, quantitative data from 100 caregivers completing self-administered surveys were used. A series of one-way ANOVAs and multiple regression analyses were conducted to address study aims. Results indicate that care-recipient cognition and behavioral problems moderated the relationship between caregiving onset and emotional health outcomes for caregivers who experienced a more abrupt entry into the caregiving role. Results suggest the importance of considering different onset transitions and moderating factors within the caregiving career to target clinical interventions. Implications for social work practice are discussed.     

Deciding to Institutionalize: Caregiving Crisis,Intergenerational Communication,and Uncertainty Management for Elders and Their Children in Shanghai

This phenomenological study integrated crisis theory, social identity theory, and uncertainty management theory to conceptualize the decision-making process around institutionalization among nursing home residents and their children in Shanghai. I conducted face-to-face, semistructured interviews with 12 dyads of matched elders and their children (N = 24). The findings suggest that caregiving crises triggered intergenerational communication about caregiving alternatives and new arrangements, although each generation had different stances and motivations. Children finalized the decision by helping their parents to manage the uncertainties pertaining to institutionalization. This study sheds light on caregiving decision-making dynamics for the increasing aging population across cultures.     

Perspectives of South African caregivers in receipt of Child Support Grants: Implications for family strengthening interventions

Cash transfers have delivered measurable benefits for poor and vulnerable children in low‐ and middle‐income countries. However, on its own, a cash transfer is insufficient to promote holistic child well‐being. In the quest for appropriate complementary family support services, known as ‘cash plus’ programing, this qualitative study sought to explore the perspectives of a group of South African caregivers, all of whom were in receipt of a Child Support Grant (CSG), in relation to their own caregiving and family functioning. Critical areas of support to families were identified to further scale up the already positive impacts of the CSG, such as mental health services, social supports for caregivers, decreasing levels of poverty and growing caregiving knowledge and skills. Key conclusions are that improving the quality and integration of public services and developing culturally appropriate and evidence‐based family strengthening programmes are critical to complement and boost the positive impacts of the CSG.     

Can Cultural Values Help Explain the Positive Aspects of Caregiving Among Chinese American Caregivers?

This study used an adaptation of the caregivers' stress model to examine the positive aspects of caregiving with 113 Chinese American family caregivers who provided care to their elderly relatives. The hierarchical multiple regression analysis indicated that combination of caregiver background characteristics, stressors, and cultural values had direct effects on positive aspects of caregiving. Unlike previous studies in which cultural values were not measured, this study found that cultural values helped explain positive aspects of caregiving. Specifically, cultural values, caregiver's health, and caregiver's age predicted positive aspects of caregiving. Service implications are discussed based upon the findings.     

Exploring how workplace and social policies relate to caregivers’ financial strain

Informal caregiving is a critical component of the US long-term care system, but can have significant negative impacts on caregiver employment, finances, and well-being. An online survey of Colorado caregivers was piloted in 2016–17 to explore whether workplace and social policies such as access to paid family leave and public health insurance can buffer the negative financial impacts of caregiving and help caregivers to remain in the workforce. Using standardized measures, the survey assessed caregivers’ employment and financial status, well-being (physical and mental health, caregiver strain, benefits of caregiving), access to workplace supports, and covariates (e.g., caregiver demographics, health, social support, and service utilization). Ninety-five caregivers, recruited through community agency partners, completed the survey. Respondents were predominately female (89%), middle-aged (M = 57), non-Hispanic White (64%) or Latino/a (22%), and caring for a parent (40%) or spouse (30%) for over one year. Half (51%) reported working full- or part-time jobs, while 16.4% had stopped working because of caregiving. In multivariate regression modeling, predictors of financial strain included the care recipients’ financial strain and the caregiver’s reduction or ceasing of work. Medicare may be protective to minimize caregivers’ need to reduce or cease work. Implications for caregivers’ ability to stay engaged in the workforce and prepare for their own retirement are explored.     

The Impact of Social Capital on Labor Force Participation: Evidence from the 2000 Social Capital Benchmark Survey

Objectives . Few studies apply the concept of social capital to labor force participation. In this research, I study the relationship between friendship networks and labor force participation as represented by employment and hours worked. Methods . I test five hypotheses representing social capital with network structure, network quality, and network diversity using nationally representative data from the 2000 Social Capital Benchmark Survey. Since this survey enables comparisons across racial/ethnic and gender groups, I am also able to specify how social capital interacts with race/ethnicity and gender to influence labor force participation, while controlling for other prominent theoretical concerns such as human capital theory. Results . I find that friendship networks are generally positively related with increased labor force participation. Further, I find significant social capital differences based on race/ethnicity and gender. Conclusions . I illustrate that social capital can be applied across a broader racial/ethnic/gender spectrum. The findings suggest that programs that attempt to bring valuable labor market information to individuals and communities lacking employment–related information are likely to be effective in reducing inequality, especially if combined with programs for developing human capital.     

Older people within transnational families: the social policy implications

Given that more people 'permanently' migrate today than in the past, migration has taken on a heightened profile internationally. Such mobility raises fundamental social policy questions of entitlement and (re)negotiation of caregiving obligations and arrangements. Social policy has traditionally approached problems and developed responses within the confines of the nation-state and faces difficulties in recognising and addressing issues arising from mobility. Migration contributes to family being 'stretched' beyond national boundaries to become dispersed, global or transnational families. This article focuses attention on one dimension of transnational living – older people as members of transnational families. The combination of increasing population mobility and the elongation of new post-retirement life-stages is resulting in a set of pressing social policy issues. It explores immigration, pension eligibility and portability, and social services and caregiving issues. To illustrate these issues the article draws on New Zealand's diverse transnational family forms and experience.     

ETHNICITY NOT RACE: A PUBLIC HEALTH PERSPECTIVE

This article presents an argument, from a public health perspective, against the use of the term ‘race’ and for its replacement by the term ‘ethnicity’. Historically, the rise of the race concept in society was dependent on its undeserved status as an objective scientific and biological category and was associated with strategies of exclusion and political domination. Mainstream science played a key role in the rise of the race concept but has since largely abandoned it in face of evidence from population genetics. Similarly, the public health movement has historically been concerned with race/ethnicity as a determinant of unequal health status, but the race term has now all but disappeared from the Australian public health literature, where it has been replaced by the concept of ethnicity. Ethnicity is a complex social variable, with cultural and political dimensions, but no biological dimension. Adopting a public health perspective on ethnicity which recognises the fluid and contested nature of this socio‐political variable, whilst seeking to make explicit its relevance and definitional limits, allows us to dispense with the race concept altogether, since race has no additional explanatory or strategic value above that of ethnicity. The race term is still commonly used, however, in general conversation and in the media. The persistence of the race concept and of racism is difficult to explain but may be related historically to the politics of nationalism, and in modern times to the politics of difference and identity that characterise the modern multicultural nation‐state. Abandoning the terminology of race leaves racism without any logical basis, and may contribute to a process of social change, although it cannot be expected to eliminate the phenomenon of racism.     

Veterans’ Informal Caregivers in the “Sandwich Generation”: A Systematic Review Toward a Resilience Model

Social work theory advanced the formulation of the construct of the sandwich generation to apply to the emerging generational cohort of caregivers, most often middle-aged women, who were caring for maturing children and aging parents simultaneously. This systematic review extends that focus by synthesizing the literature on sandwich generation caregivers for the general aging population with dementia and for veterans with dementia and polytrauma. It develops potential protective mechanisms based on empirical literature to support an intervention resilience model for social work practitioners. This theoretical model addresses adaptive coping of sandwich- generation families facing ongoing challenges related to caregiving demands.     

Culture and context: exploring attributions and caregiving approaches of parents of children with an intellectual disability in urban India

We utilized a sociocultural lens and a qualitative approach to examine causal attributions and caregiving approaches of parents of children with an intellectual disability in a mid‐sized Indian city. Sixteen mothers and three fathers participated in a semi‐structured interview. Findings elucidate participants' active processing of the cause of their child's intellectual disability. They seemed to simultaneously draw upon religious, biological and situational factors to construct an explanation. As far as caregiving approaches, most parents reported moving away gradually from mainstream medicine to alternative medicine and physiotherapy and from regular education settings to special schools. The themes highlight the role of sociocultural factors and also cross‐cultural similarities in parental causal attributions and caregiving approach. The findings are discussed in the context of implications for social work practice and policy in India.     

A Comparison of Majority-race Children With and Without a Minority-race Friend

Majority‐race (black or white) ¹ elementary school children with and without a minority friend (black or white) in their classroom were compared on measures of social, behavioral, and affective characteristics. Analyses focused on 260 4th through 6th grade students who were racial majorities in their classrooms and had at least one reciprocated friendship in the classroom‐based peer group. Overall, the results were consistent with the scenario that majority children with minority friends are high status, prosocial, and socially satisfied members of the peer group, compared to majority children without a cross‐race friendship, although race and gender differences were observed. In contrast, class‐level characteristics (e.g. class size, the proportion of participating children in each classroom of the majority race, and the number of minority‐race children in the classroom) were not predictive of whether a majority child had a cross‐race friendship or not. Implications for the current status of black– white relations among our youth were discussed.     

Gerontological Social Work Student-Delivered Respite: A Community-University Partnership Pilot Program

ABSTRACT

This study describes a community-university partnership to support a gerontological social work student-delivered respite program, the Houseguest Program (Houseguest). Houseguest was designed using a community-engaged scholarship model of integrating research, teaching, and service. Houseguest was piloted with a small group of community-dwelling, coresiding dementia caregivers and care recipients. We examined caregivers’ experiences with student-delivered respite using qualitative data analysis. Thematic analysis produced 8 themes: (a) respite from full time caregiving role, (b) information on caregiving strategies, (c) no-cost supportive services, (d) opportunity for care recipients to socialize, (e) tailored activities for care recipients, (f) rapport-building between students and family dyad, (g) reciprocity between students and family dyad, and (h) program continuation. We conclude with a proposed community-engaged scholarship model for dementia caregiving. Through a community-university partnership, Houseguest reduced the impact of caregiver burden and created an opportunity for students to serve families affected by dementia through respite and tailored activities.     

Japan's Radical Reform of Long-term Care

Japan's mandatory long‐term care social insurance system started in 2000. Many important choices about the basic shape and size of the system, as well as a host of details, were necessary when the program was being planned. It represents a reversal from earlier steps toward a tax‐based direct‐service system, and is based on consumer choice of services and providers. The benefits are in the form of institutional or community‐based services, not cash, and are aimed at covering all caregiving costs (less a 10 percent co‐payment) at six levels of need, as measured by objective test. Revenues are from insurance contributions and taxes. The program costs about $40 billion, and is expected to rise to about $70 billion annually by 2010 as applications for services go up. There are about 2.2 million beneficiaries, about 10 percent of the 65+ population. The program has operated within its budget and without major problems for two years and is broadly accepted as an appropriate and effective social program.