Ethnic Variations in Dementia Caregiving Experiences

Abstract

The proportion of minority elders with dementia in the United States is projected to rise substantially. This study elicited perceptions of the caregiving experience from informal caregivers of persons with dementia, across different ethnicities. Six focus groups with 47 dementia caregivers of African-American, Chinese-American, Euro-American, and Hispanic-American ethnicities were conducted. Caregiving roles, concern about the person with dementia, and unmet information and resource needs were expressed similarly. However, perspectives differed across ethnic groups on stigma surrounding dementia, benefits of caregiving, spirituality/religion to ease caregiving burden, and language barriers and discrimination. Findings suggest that interventions to reduce disparities in dementia care quality need to address ethnic variations in caregiving experiences.     

Ethnic Differences in Women's Emotional Reactions to Parental Nonsupportive Emotion Socialization

Recent evidence suggests that the association between parents’ use of nonsupportive emotion socialization practices and their children's subsequent negative emotional outcomes varies based on ethnicity. The goal of this study is to test the proposition that African American women interpret parental nonsupportive emotion socialization practices less negatively than European American women. In this study, 251 European and African American women completed a measure on recalled feelings when their parents engaged in nonsupportive emotion socialization practices during childhood. Results indicated that African American women reported feeling more loved and less hurt and ashamed than European American women when their parents enacted nonsupportive emotion socialization practices such as ignoring, punishing, minimizing, and teasing them when distressed. Possible mechanisms for this difference and the need for additional research exploring ethnic differences in emotion socialization and its effects on adjustment are discussed.     

Rural Arab Families Coping with Caregiving

SUMMARY

This research examines the coping patterns of the rural Arab family in caring for a chronically ill elderly relative. The Arab community in Israel is in transition as a result of modernization with changes occurring in the traditional family structure, family norms and living arrangements. This study was conceptualized within the framework of intergenerational solidarity versus ambivalence and utilized a qualitative approach based on the phenomenological paradigm. Data were collected from 10 family units with a chronically ill homebound elder, by means of in-depth interviews. Four people were selected from each unit including the elder, his/her spouse-the primary caregiver-and two other secondary caregivers, usually sons and daughters-in-law. The data indicate the uniqueness of coping patterns among these caregivers in regard to two main components, which are contradictory to findings in the family caregiving literature: differences in the gender of child caregivers and the family readiness to use assistance from formal support systems.     

Racial and Ethnic Differences in Experiencing Parents’ Marital Disruption During Late Adolescence

Using panel data from 9,252 adolescents in the National Education Longitudinal Study, this study finds that among children who experience parents’ marital disruption during late adolescence, European, Asian, and African American adolescents exhibit wider and greater maladjustment both before and after the disruption than their Hispanic American counterparts. This finding lends general support to the hypothesis of prevalence of disadvantages, although it is less consistent with the hypothesis of prevalence of divorce. Moreover, whereas Asian American adolescents in predisrupted families are more vulnerable to a shortage of family social resources, their African American peers are affected more by a shortage of financial/human resources. Finally, postdisruption effects on non‐Hispanic American adolescents are either completely or partially attributable to predisruption factors.     

Racial and Ethnic Determinants of Interracial and Ethnic Trust

The purpose of this cross-sectional study was to discern which individual factors are associated with interracial/ethnic trust among a national probability sample of African Americans, Latinos, and non-Hispanic whites. Using national data from the 2000 Community Benchmark Survey, the multiple regression results indicate that, even after controlling for education and income, African Americans and Latinos reported significantly lower levels of interracial/ethnic trust than did non-Hispanic whites. Additionally, separate regression equations indicate that predictors associated with interracial/ethnic trust varied by racial and ethnic group. Implications and future research are discussed.     

Racial and Ethnic Differences in the Timing of First Marriage and Smoking Cessation

Using data from the National Longitudinal Survey of Youth 1979 (N = 4,050), we consider the relationship between the timing of family formation and positive changes in health behavior. Theories that predict both positive and negative associations are tested. The findings suggest that both mechanisms operate and that the direction of the association depends on the respondent’s race or ethnicity. Whites who marry early are less likely to quit smoking, whereas Whites who marry on time and Blacks and Hispanics who marry at all ages are more likely to quit. The analysis refines the understanding of how family formation shapes changes in health behaviors differentially across the life course, and it underscores the difference in this process for individuals from different racial and ethnic backgrounds.     

Race Differences in Family Experience and Early Sexual Initiation: Dynamic Models of Family Structure and Family Change

We examine the effects of family structure on age at first sexual intercourse before marriage for a recent cohort of women. Previous research on the linkage between family structure and sexual initiation has employed relatively crude measures of family structure—typically a snapshot of the respondent's family structure at age 14. We use retrospective parent histories from the 1979–1987 National Longitudinal Survey of Youth to construct dynamic measures of family structure, using information on the number and types of parents in the respondent's household between birth and age 18. We use these measures in proportional hazard models to test the effects of prolonged exposure to a single‐mother family, prolonged absence of a biological father, parental presence during adolescence, and family turbulence. For White women, age‐specific rates of first sexual intercourse are significantly and positively associated with the number of family transitions; for Black women, age‐specific rates are significantly and positively associated with having resided in a mother‐only or father‐only family during adolescence. Net of other effects of family structure, we find no significant effects for White or Black women of being born out of wedlock, prolonged exposure to a single‐mother family, or prolonged absence of a biological father. Our results for White women are consistent with a turbulence hypothesis, whereas for Black women our results suggest the importance of family structure during adolescence. For neither White nor Black women are our results consistent with hypotheses positing earlier initiation of sexual activity for women with prolonged exposure to a single‐mother or father‐absent family.     

Chapter 6. Issues in Caregiving

SUMMARY

Some 10 to 29% of persons over 65 in the United States are sufficently physically, cognitively, or emotionally impaired to need some level of caregiving from their informal and formal support systems. Unfortunately, there are still some older persons who need care, but care is either not provided, inadequate, or involves some form of mistreatment. This chapter discusses the difficulties of maltreatment and substance abuse.     

Racial and Ethnic Differences in Problem Gambling among College Students

The college years are a formative period where the risk for development of problematic gambling is high. Research examining racial and ethnic differences in gambling behaviors has been limited and inconsistent. The aims of this study were to examine racial and ethnic differences in problem gambling among a large sample of college students. Undergraduates (N = 3058) from a large southern university completed an online screening questionnaire which included demographics, gambling frequency, gambling expenditure (i.e. money lost) in the previous 6 months, and the South Oaks Gambling Screen (SOGS). Negative binomial regression results indicated that Asian participants gambled less frequently than participants who were Caucasian or Hispanic/Latino(a), but spent more money than participants who were African-American (AA)/Black or Hispanic/Latino(a). A significantly larger proportion of Asian students met probable pathological gambling criteria (SOGS 5+; 7.8 %) and at-risk gambling criteria (SOGS 3+; 16.3 %)) than Caucasian (5.2; 10.1 %), AA/Black (3.9; 10.2 %), or Hispanic/Latino(a) (3.6; 9.4 %) students. Additionally, a significantly larger proportion of Asian students endorsed problematic gambling indicators such as lying about losses, feeling guilty about gambling, feeling like they had a gambling problem, being criticized for their gambling, feeling like they couldn’t stop gambling, losing time from school or work due to gambling, having a family history of problem gambling, and arguing with close others about their gambling than Caucasian, AA/Black or Hispanic/Latino(a) students. Results suggest that Asian students may be a high-risk sub-group of college gamblers, and that there is a critical need for targeted interventions for this population.     

Caregiving transitions: Developmental and gendered perspectives

Providing care for family members is a life event that both reflects and influences family dynamics. Caregiving careers, or the length of time a person provides care, are characterized by a series of transitions to which they must continuously adapt. Women are more likely than men to assume the caregiver role and this role encompasses gender inequalities associated with work and caregiving expectations. This article presents qualitative data from interviews conducted with caregivers who participated in a community-based supportive services program. The experiences of these women provide insight into how caregivers transition into their role, strategies for supporting new and experienced caregivers, and their concerns for their future. Developmental and gendered perspectives of caregiving were used as a context to analyze their experiences.     

Racial Differences in Exposure and Reactivity to Daily Family Stressors

Using data from the National Study of Daily Experiences, the authors examined racial differences in exposure and reactivity to daily stressors involving family members. Respondents included African American and European American adults age 34 to 84 (N = 1,931) who participated in 8 days of daily interviews during which they reported on daily stressors, affect, and physical health symptoms. The results revealed racial similarities in family stressor exposure. Both races were also emotionally reactive to family arguments and family network events (i.e., events that happen to a family member), whereas African Americans were more physically reactive to family arguments. For African Americans, reactivity to family arguments endured; the increased negative affect and physical symptoms associated with family arguments lasted into the next day. The findings provide evidence for racial similarities and differences, suggesting that family relationships are universally stressful, whereas the negative effects of family stressors are more enduring among African Americans.     

Real men, real husbands: Caregiving and masculinities in later life

Drawing on data from in-depth personal interviews with a sample of fifty-three older men caring for their impaired wives, authors report findings on these men's caregiving experience, specifically on the way they see themselves as men within such role. Through analytic methods based upon content analysis and open coding, authors found that when describing their gendered understanding of themselves participants evidenced several negotiations with the dominant masculine ideology in order to maintain their sense of masculinity and legitimate their presence in a feminine role. This was accomplished by reframing their definition of a man and reinforcing that of a husband and by retaining varying degrees of power over the caregiving relationship. The social visibility of the role within particular gendered community-based social networks was found to be important in shaping these older men's masculinities.     

Racial Differences in Sexual and Fertility Attitudes in an Urban Setting

Using data from the Project on Human Development in Chicago Neighborhoods (neighborhood N= 77; individual N= 951), we consider the extent to which African American youth maintain sexual and fertility‐related norms that support early sexual activity and childbearing and examine the robustness of racial differences in sexual attitudes to controls for neighborhood, family, and individual characteristics. At a minimum, neighborhood economic disadvantage accounts for 26% of the baseline increased likelihood of holding attitudes that encourage early sexual activity among African American youth when compared with Whites. Neighborhood‐, family‐, and individual‐level factors account for 67% of the race difference in sexual attitudes. Implications for contextual and race‐based theories of sexual and fertility norms are discussed.     

Health Status,Living Arrangements,and Service Use at 100: Findings From the Oporto Centenarian Study

ABSTRACT

This paper describes the sociodemographic characteristics, health status, and service use of centenarians living in the community and centenarians residing in an elder care facility/nursing home and examines their main differences. Participants were 140 centenarians from the population-based Oporto Centenarian Study (M_age = 101.2; SD = 1.6). Main findings revealed that the majority of the centenarians lived at home with their family members (57.9%). Increased health care needs, living alone, and family caregiving constraints were the most common reasons for entering a nursing home. Community-dwelling centenarians were cared for mostly by their children and were less dependent and in better cognitive health than those who resided in a nursing home. Differences were found in the pattern of health service use according to the centenarians’ residence, ability to pay medical expenses, and dependency level. Findings highlight the need for an accurate assessment of caregiving support systems, particularly family intergenerational duties, and of the factors constraining the access and use of health and social services. Policy makers may be guided by the insights gained from this research and work toward improvement of support options and removal of barriers to service access.     

Family Cultural Socialization,Ethnic Identity,and Self-Esteem

Abstract

Using a Web-based survey, this study of 82 adult international adoptees examined the relationship between parental support for cultural socialization and its effect on adoptees' selfesteem. Feelings of belongingness and ethnic identity were predicted to serve as mediators between the central variables. The results showed a positive relationship between cultural socialization and selfesteem, which was mediated by a feeling of belongingness and one aspect of ethnic identification (marginality) among Asianborn international adoptees. These data suggest that counselors should raise awareness and knowledge of adoptive parents about the importance of cultural continuity in the child's upbringing.     

Ethnic and Marital Differences in Family Structure,Risk Behaviors,and Service Requests Among Young Minority Fathers

The purpose of this study was to examine ethnic and marital status differences in family structure, risk behaviors and service requests among African American and Hispanic adolescent fathers participating in a community-based fatherhood program. Demographic factors, risk behaviors, and service requests were gathered at program entry. The results indicated that each group demonstrated distinct patterns associated with family structure, sexual risk behaviors, substance use, and criminal behavior. In comparison to African American fathers, Hispanic fathers were younger and were more likely to be married and present at the delivery of their child. African American fathers reported having more children than Hispanic fathers. Disparities in school-related measures were also found, with African American fathers having higher high school graduation rates than Hispanic fathers. The impact of marriage on risk behaviors had mixed results. Services requests were similar for both groups. The finding that different ethnic groups have specific patterns of risk behaviors highlights the importance of considering the ethnic composition of a population when developing future research and interventions.     

Explicit Versus Implicit Family Decision-Making Strategies Among Mexican American Caregiving Adult Children

Changing U.S. demographics make it increasingly vital to investigate experiences of Latinos caring for aging parents, with specific emphasis on how these families, who often value family closeness, make decisions about caregiving. This study investigates relationships among use of implicit versus explicit decision-making strategies, generation since immigration, and orientation toward family. Findings suggest that those with more recent immigration to the United States were more likely than those who immigrated longer ago to describe family decision making about their parents' care as implicit. Those that were classified as using predominately implicit decision making were also found to be not significantly different from those classified as predominantly explicit with regard to their overall support of a collective orientation toward family. There were exceptions to this, however, regarding two specific aspects of orientation toward family: engagement in shared activities with family members and avoiding family conflict by making choices that are consistent with the family values. In both cases those categorized as implicit expressed stronger endorsement of these specific values. These findings suggest that the relationship between family decision-making strategies, generation since immigration, and orientation toward family is more complex than suggested previously in the literature. Implications for future research and practice are offered.