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Nkimbeng M, Yam H, Aswani T, Russell WN, Shippee TP, Gaugler JE. Perceptions of Dementia and Dementia Care Among African Immigrants in Minnesota: Insights From Community Conversations. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae094. [PMID: 38809762 DOI: 10.1093/geronb/gbae094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVES This qualitative descriptive study explored the perceptions of dementia, dementia care, and caregiving within the African immigrant community. METHODS Six community conversations (focus groups) were held with 24 participants. Three conversations were led by project advisory board members and utilized a 12-question conversation guide. The recorded conversations were transcribed and analyzed using thematic analysis. RESULTS Of the 24 African immigrants who participated, 52% were 55-75 years old, 67% identified as female, and 39% were married or cohabitating. Twenty percent were currently providing care to a relative with dementia and 40% had provided care to a relative with dementia in the past. Four themes were identified. These included (1) attitudes toward mental health, illnesses, and poor health, (2) community attitudes toward dementia, and dementia caregiving, (3) barriers to dementia care and caregiving, and (4) current dementia care resources in the African immigrant community. DISCUSSION The findings show that African immigrant cultural beliefs significantly shape dementia care and caregiving attitudes, preferences, and behavioral practices. African immigrants' cultural backgrounds influence (or have the potential to influence) timely access and engagement in dementia care. And, depending on how deeply held these cultural beliefs are, they could affect dementia care and caregiving both positively and negatively. With the rapidly growing immigrant older adult population, there is a need for systemic strategies to facilitate affordable and culturally responsive dementia care for African immigrants and other minoritized older adults.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Managment, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Hawking Yam
- Division of Health Policy and Managment, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Truphosa Aswani
- Division of Health Policy and Managment, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Tetyana P Shippee
- Division of Health Policy and Managment, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joseph E Gaugler
- Division of Health Policy and Managment, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Chen S, Lou VWQ, Leung R, Yu DSF. Meaning-making of dementia caregiving: A systematic review of qualitative studies. Int J Nurs Stud 2024; 158:104848. [PMID: 39043114 DOI: 10.1016/j.ijnurstu.2024.104848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Being the backbone of informal care for people living with dementia, caregivers suffer overwhelming physical and psychological challenges in their daily caregiving experience. Proactive coping strategies to alleviate the caregiving burden are of utmost importance. Meaning-making emerges as an effective coping approach to benefit caregivers and mitigate their care burden. However, the conceptualisation of meaning-making on its dimensions and process has been ambiguously identified. OBJECTIVES To synthesise the qualitative research evidence on meaning-making in a dementia context to identify: (1) the situational dimension in making sense of caregiving scenarios, and (2) how the meaning-making process evolves during dementia caregiving. METHODS This systematic review identified 62 qualitative studies published between 1969 and 2022 from the major databases. Eligible studies met the following inclusion criteria: (1) having informal caregivers of people living with dementia; (2) involving meaning-making of care experience; (3) adopting qualitative design; and (4) full-text of research articles. The risk of bias was evaluated using the Clinical Appraisal Skills Programme checklist. By using Qualitative Evidence Synthesis, themes relevant to critical dimensions and phases of meaning-making were generated from the extracted data. RESULTS Sixty-two studies involving 2487 subjects were synthesised investigating the critical dimensions and process of meaning-making of dementia care experience. Results indicated that the dementia care experience can be made sense of in several folds: (1) it involved complicated demands from people living with dementia and requires customised care; (2) the dynamics of dyadic interactions with dilemma and ambivalence; and (3) adaptive coping encapsulating perceptions of loss and growth, complied and integrated values, balanced expectations of care and self, and improvement in self-efficacy. The meaning-making process underwent phases of meaning creation (meaning created in initial encounter with dementia symptoms), meaning appraisal (assimilation and accommodation pathways for appraisal), and meaning adherence (integration of the appraised meanings). CONCLUSION Findings suggest meaning-making of dementia caregiving is a multi-faceted and multi-phased recursive process. Future implications give directions on the facilitation of meaning-oriented interventions to enhance the awareness of caregiving role and the knowledge of dementia care, learn techniques of reframing and restructuring, and seek meaningful perspectives; and to adopt strategies to overcome the barriers for meaning-making by empowering self-identity, roles and expectations, and the dyadic relationship. In addition, our findings inform future advancement in the conceptualisation and measurement of meaning-making in the context of family caregiving. Optimisation of the meaning-making process inspires professional assistance to enhance caregivers' coping for dementia care experience.
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Affiliation(s)
- Shuangzhou Chen
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Reynold Leung
- Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong.
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Bechthold AC, McIlvennan CK, Matlock DD, Ejem DB, Wells RD, LeJeune J, Bakitas MA, Odom JN. "Things That You Thought Mattered, None of That Matters": A Qualitative Exploration of Family Caregiver Values following Left Ventricular Assist Device Implantation. J Cardiovasc Nurs 2024:00005082-990000000-00189. [PMID: 38786984 DOI: 10.1097/jcn.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND Intentional exploration, or elicitation, of patient and family values-who/what matters most-is critical to the delivery of person-centered care, yet the values elicitation experiences of family caregivers have been understudied. Understanding caregiver experiences discussing, reflecting upon, and acting on their values is critical to optimizing health decisions after left ventricular assist device (LVAD) implantation. OBJECTIVE The aim of this study was to explore the values elicitation experiences of family caregivers of individuals with an LVAD in the postimplantation period. METHODS This was a qualitative descriptive study of LVAD caregivers recruited from an outpatient clinic in the southeast United States. After completing one-on-one semistructured interviews, participants' transcripts were analyzed using thematic analysis. RESULTS Interviewed caregivers (n = 21) were 27 to 76 years old, with 67% African American, 76% female, 76% urban-dwelling, and 62% a spouse/partner. LVAD implantation was an impactful experience prompting caregiver reevaluation of their values; these values became instrumental to navigating decisions and managing stressors from their caregiving role. Three broad themes of caregiver values elicitation experiences emerged: (1) caregivers leverage their values for strength and guidance in navigating their caregiving role, (2) LVAD implantation prompts (re)evaluation of relationships and priorities, and (3) caregivers convey their goals and priorities when deemed relevant to patient care. CONCLUSIONS Having a care recipient undergo LVAD implantation prompted caregivers to reevaluate their values, which were used to navigate caregiving decisions and stressors. Findings highlight the need for healthcare professionals to engage and support caregivers after LVAD implantation.
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Ko E, Helsabeck NP, Yang Y, Rose KM. A mediating role of self-care difficulty in the association between caregiver strain and the impact of caregiving on health: A cross-sectional secondary analysis. Geriatr Nurs 2024; 57:179-187. [PMID: 38663186 DOI: 10.1016/j.gerinurse.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/23/2024] [Accepted: 04/12/2024] [Indexed: 06/04/2024]
Abstract
Caregivers of people living with dementia face strain, reduced self-care, and poorer health status. However, research examining the links among those outcomes is limited. We explored the association between caregiver strain and the impact of caregiving on health status and identified the mediating role of self-care difficulty in this association. In the national caregiving dataset "Caregiving in the U.S. 2020," we included 312 caregivers in this study. Demographics, caregiving characteristics, a composite scale for caregiver strain, and single-item questions for the impact of caregiving on health status and self-care difficulty were used. Descriptive statistics and mediation analysis were conducted. Results revealed that higher caregiver strain was associated with higher self-care difficulty (OR 2.054, p < .001) and negative health changes due to caregiving (OR 2.719, p < .001). Self-care difficulty partially mediated this association. These results indicated the need to explore interventions or resources to offer caregivers to encourage their self-care awareness and activities.
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Affiliation(s)
- Eunjung Ko
- College of Nursing, The Ohio State University, Columbus, OH, USA.
| | | | - Yesol Yang
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Karen M Rose
- College of Nursing, The Ohio State University, Columbus, OH, USA
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Williams BR, Brady SS, Levin EC, Brown O, Lipman TH, Klusaritz H, Nodora J, Coyne-Beasley T, Putnam S, Gahagan S, Burgio KL. Black women's perspectives on bladder health: Social-ecological and life course contexts. Neurourol Urodyn 2024; 43:849-861. [PMID: 38451032 PMCID: PMC11138321 DOI: 10.1002/nau.25437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/21/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
AIMS This paper explores Black women's perspectives on bladder health using a social-ecological conceptual framework and life course perspective. METHODS We conducted a directed content analysis of data from the Study of Habits, Attitudes, Realities, and Experiences (SHARE), a focus group study by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. Analysis was conducted on data from five focus groups and a member-checking session where all participants self-identified as Black or African American. RESULTS Forty-two participants aged 11-14 or 45+ years reported life course experiences with their bladder. The intersection of race and gender was the lens through which participants viewed bladder health. Participants' accounts of their perspectives on bladder health explicitly and implicitly revealed structural racism as an explanatory overarching theme. Participants described (a) historically-rooted and still pervasive practices of discrimination and segregation, engendering inequitable access to quality medical care and public facilities, (b) institutional barriers to toileting autonomy in educational and occupational settings, promoting unhealthy voiding habits, (c) internalized expectations of Black women's stereotyped role as family caregiver, compromising caregiver health, (d) lack of reliable information on bladder health, leading to unhealthy bladder behaviors, and (e) potentially stress-related comorbid chronic conditions and associated medication use, causing or exacerbating bladder problems. CONCLUSIONS Bladder health promotion interventions should address social-ecological and life course factors shaping Black women's bladder health, including social and structural barriers to accessing equitable health information and medical care.
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Affiliation(s)
- Beverly R Williams
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Sonya S Brady
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Elise C Levin
- Division of Community Health Services, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Oluwateniola Brown
- Division of Female Pelvic Medicine and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Terri H Lipman
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Heather Klusaritz
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jesse Nodora
- Division of Applied Sciences, Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA
| | - Tamera Coyne-Beasley
- Department of Pediatrics, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - Sara Putnam
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sheila Gahagan
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Kathryn L Burgio
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
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Ellis KR, Raji D, Pennings JS, Thorpe RJ, Bruce MA. Caregiving and Obesity among Black American Adults. SOCIAL WORK RESEARCH 2024; 48:38-47. [PMID: 38455109 PMCID: PMC10915901 DOI: 10.1093/swr/svae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/19/2022] [Accepted: 01/26/2023] [Indexed: 03/09/2024]
Abstract
Black American adults often report higher rates of obesity and caregiving compared with other racial or ethnic groups. Consequently, many Black American caregivers and care recipients are obese or have obesity-related chronic conditions (e.g., diabetes, hypertension). This study investigated associations between caregiving and obesity among Black Americans, including the role of health behaviors and chronic conditions. The sample included data from 2015 and 2017 Behavioral Risk Factor Surveillance System for non-Hispanic Black (NHB) or African American adult caregivers (n = 2,562) and noncaregivers (n = 7,027). The association between obesity (dependent variable) and caregiving status, fruit consumption, vegetable consumption, physical activity, and number of chronic conditions (independent variables) were evaluated using hierarchical binomial logistic regressions. Caregiving, being female, and chronic conditions were associated with higher odds of obesity, while physical activity was associated with lower odds of obesity. Physical activity, diet, and chronic conditions did not account for differences in obesity among caregiving and noncaregiving Black Americans. Increasing understanding of health behaviors and chronic disease burden of NHB caregivers has implications for programs aiming to improve obesity-related outcomes for caregivers and recipients. Future research should investigate multilevel factors that contribute to observed differences.
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Affiliation(s)
- Katrina R Ellis
- PhD, MPH, MSW, is assistant professor, School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Dolapo Raji
- MPH, MHI, is research associate specialist intermediate, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jacquelyn S Pennings
- PhD, PStat, is research associate professor, Department of Orthopaedic Surgery, Department of Biostatistics, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roland J Thorpe
- PhD, is professor, Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Baltimore, MD, USA
| | - Marino A Bruce
- PhD, is associate dean for research and clinical professor, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
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Saylor MA, Pavlovic N, DeGroot L, Peeler A, Nelson KE, Perrin N, Gilotra NA, Wolff JL, Davidson PM, Szanton SL. Feasibility of a Multi-Component Strengths-Building Intervention for Caregivers of Persons With Heart Failure. J Appl Gerontol 2023; 42:2371-2382. [PMID: 37707361 PMCID: PMC10840901 DOI: 10.1177/07334648231191595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Caregivers of persons with heart failure (HF) navigate complex care plans, yet support strategies often focus solely on meeting the needs of patients. We conducted a randomized waitlist control trial (N = 38) to test the feasibility and gauge initial effect size of the Caregiver Support intervention on quality of life, caregiver burden, and self-efficacy among HF caregivers. The intervention includes up to five remote, nurse-facilitated sessions. Components address: holistic caregiver assessment, life purpose, action planning, resources, and future planning. Caregivers were 93.3% female, 60% White, and 63.3% spouses. Average age was 59.4. Participants who completed the intervention reported high satisfaction and acceptability of activities. Between-group effect sizes at 16 and 32 weeks suggest improvement in quality of life (mental health) (.88; 1.08), caregiver burden (.31; .37), and self-efficacy (.63; .74). Caregivers found Caregiver Support acceptable and feasible. Findings contribute evidence that this intervention can enhance caregiver outcomes. Clinicaltrials.gov Identifier NCT04090749.
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Affiliation(s)
| | - Noelle Pavlovic
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Lyndsay DeGroot
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Anna Peeler
- King’s College London, Cicely Saunders Institute, London, United Kingdom
| | - Katie E. Nelson
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Nisha A. Gilotra
- Johns Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Jennifer L. Wolff
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | | | - Sarah L. Szanton
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
- King’s College London, Cicely Saunders Institute, London, United Kingdom
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Tay DL, Reblin M, Iacob E, Cloyes KG, Hebdon MCT, Reynaga M, Mooney K, Ellington L. Cancer Hospice Caregivers' Self-care Behaviors: The Role of Caregiving Tasks, Burden, and Mental Health. J Hosp Palliat Nurs 2023; 25:286-295. [PMID: 37347956 PMCID: PMC10524198 DOI: 10.1097/njh.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Cancer hospice family caregivers provide intensive support for patients at the end of life, sometimes at the expense of self-care. This secondary analysis examined the role of caregiving burden, activities of daily living, and mental health on self-care behaviors among cancer hospice family caregivers. Logistic regression models were adjusted for sociodemographic and caregiver characteristics, and model fit was evaluated with Hosmer-Lemeshow tests. Participants (N = 86) were mostly women (n = 62, 72.09%), White (n = 76, 88.37%), and spousal caregivers (n = 44, 51.16%). Almost half reported not getting enough rest (47.67%), time to exercise (47.67%), or time to slow down and rest when feeling ill (46.51%). Caregivers with better mental health reported being more likely to have enough time to exercise (adjusted odds ratio [OR adj ], 1.15, [1.05, 1.26]; P = .004), rest (OR adj , 1.11, [1.01, 1.22]; P = .031), and slow down when ill (OR adj , 1.16, [1.04, 1.30]; P = .010). Controlling for sociodemographic and caregiver characteristics, men caregivers had 88% lower odds of being able to rest when ill (OR adj , 0.12, [0.03, 0.52]; P = .005) compared with women. Number of care tasks, not caregiving burden, was associated with self-care behaviors. Findings provide a preliminary understanding of factors related to caregiver self-care and have implications for increased assessment of caregiver mental health and self-care needs to better support family-oriented hospice care.
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Affiliation(s)
- Djin L. Tay
- University of Utah, College of Nursing, Salt Lake City, UT, USA
| | - Maija Reblin
- University of Vermont Cancer Center, Cancer Control and Population Health Sciences, Burlington, VT, USA
| | - Eli Iacob
- University of Utah, College of Nursing, Salt Lake City, UT, USA
| | - Kristin G. Cloyes
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | | | - Miranda Reynaga
- University of Michigan, Department of Psychology, Ann Arbor, MI, USA
| | - Kathi Mooney
- University of Utah; Co-Leader Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Lee Ellington
- University of Utah, College of Nursing, Salt Lake City, UT, USA
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Park T, Sloan DH, Cruz-Oliver DM, Reid MC, Czaja S, Adelman RD, Dignam R, Phongtankuel V. Black Caregivers' Symptom Management, Cultural, and Religious Experiences With Home Hospice Care. J Pain Symptom Manage 2023; 66:116-122.e1. [PMID: 37084826 PMCID: PMC10524479 DOI: 10.1016/j.jpainsymman.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023]
Abstract
CONTEXT Informal Black or African American (Black/AA) caregivers are at high risk for caregiver burden due to both greater caregiving responsibilities and unmet needs. However, there has been minimal research on the challenges Black/AA caregivers face after hospice enrollment. OBJECTIVES This study seeks to address this knowledge gap by applying qualitative methods to understand Black/AA caregivers' experiences around symptom management, cultural, and religious challenges during home hospice care. METHODS Data from small group discussions with 11 bereaved Black/AA caregivers of patients who received home hospice care were qualitatively analyzed. RESULTS Caregivers struggled most with managing patients' pain, lack of appetite, and decline near end of life (EoL). Cultural needs (e.g., knowing their language, having familiarity with foods) were perceived as not on top of mind for many Black/AA caregivers. However, there was a concern of stigma around mental health preventing care recipients from sharing their mental health concerns and seeking resources. Many caregivers relied on their personal religious networks rather than services provided by hospice chaplains. Lastly, caregivers reported increased burden during this phase of caregiving but were satisfied with the overall hospice experience. CONCLUSION Our results suggest that tailored approaches that target mental health stigma in the Black/AA community and reduce caregiver distress around end of life symptoms may improve hospice outcomes among Black/AA hospice caregivers. Hospice spiritual services should consider offering services complementary to caregivers' existing religious networks. Future qualitative and quantitative studies should examine the clinical implications of these results in terms of patient, caregiver, and hospice outcomes.
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Affiliation(s)
- Taeyoung Park
- Division of Geriatrics and Palliative Medicine (T.P., M.C.R., S.C., R.D.A., V.P.), Department of Medicine, Weill Cornell Medicine, New York, New York, USA.
| | - Danetta H Sloan
- Department of Health, Behavior, and Society (D.H.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dulce M Cruz-Oliver
- Division of General Internal Medicine (D.M.C-O.), Department of Medicine, Palliative Medicine Section, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Manney Cary Reid
- Division of Geriatrics and Palliative Medicine (T.P., M.C.R., S.C., R.D.A., V.P.), Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Sara Czaja
- Division of Geriatrics and Palliative Medicine (T.P., M.C.R., S.C., R.D.A., V.P.), Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Ronald D Adelman
- Division of Geriatrics and Palliative Medicine (T.P., M.C.R., S.C., R.D.A., V.P.), Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | | | - Veerawat Phongtankuel
- Division of Geriatrics and Palliative Medicine (T.P., M.C.R., S.C., R.D.A., V.P.), Department of Medicine, Weill Cornell Medicine, New York, New York, USA
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Kopel J, Sehar U, Choudhury M, Reddy PH. Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias in African Americans: Focus on Caregivers. Healthcare (Basel) 2023; 11:healthcare11060868. [PMID: 36981525 PMCID: PMC10048201 DOI: 10.3390/healthcare11060868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Alzheimer’s disease (AD) and Alzheimer’s Disease-Related Dementias (ADRD) are chronic illnesses that are highly prevalent in African Americans (AA). AD and ADRD are caused by multiple factors, such as genetic mutations, modifiable and non-modifiable risk factors, and lifestyle. Histopathological, morphological, and cellular studies revealed how multiple cellular changes are implicated in AD and ADRD, including synaptic damage, inflammatory responses, hormonal imbalance, mitochondrial abnormalities, and neuronal loss, in addition to the accumulation of amyloid beta and phosphorylated tau in the brain. The contributions of race, ethnicity, location and socioeconomic status all have a significant impact on the care and support services available to dementia patients. Furthermore, disparities in health care are entangled with social, economic, and environmental variables that perpetuate disadvantages among different groups, particularly African Americans. As such, it remains important to understand how various racial and ethnic groups perceive, access, and experience health care. Considering that the mounting data shows AA may be more susceptible to AD than white people, the demographic transition creates significant hurdles in providing adequate care from family caregivers. Furthermore, there is growing recognition that AD and ADRD pose a significant stress on AA caregivers compared to white people. In this review, we examine the current literature on racial disparities in AD and ADRD, particularly concerning AA caregivers.
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Affiliation(s)
- Jonathan Kopel
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Moumita Choudhury
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Correspondence: ; Tel.: +1-806-743-3194
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11
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Petroll AE, Quinn KG, John SA, Nigogosyan Z, Walsh JL. Factors associated with lack of care engagement among older, rural-dwelling adults living with HIV in the United States. J Rural Health 2023; 39:477-487. [PMID: 36482508 PMCID: PMC10038837 DOI: 10.1111/jrh.12732] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Most people living with HIV (PLH) in the United States are over age 50 and this sector of PLH continues to grow. Aging with HIV can be challenging due to comorbid medical conditions, mental health disorders, substance use, and lack of social and practical support. Additional challenges are faced by older PLH living in the rural United States, such as longer distances to health care, concerns over privacy and stigma, and social isolation. PLH in rural areas have higher mortality rates than urban PLH. We aimed to understand factors associated with HIV care engagement and quality of life in rural US adults over age 50. METHODS We conducted a cross-sectional study to evaluate the association between patient-level factors and a combined outcome variable encompassing multiple aspects of care engagement. FINDINGS Either online or on paper, 446 participants completed our survey. One-third of the participants (33%) were from the southern United States; one-third were women; one-third were non-White; and 24% completed the survey on paper. In multiple regression analysis, lower income, residing in the southern United States, lacking internet access at home, not having an HIV specialist provider, higher levels of stress, living alone, and longer distance to an HIV provider were all associated with lower engagement in HIV care. CONCLUSIONS Our findings demonstrated multiple potential options for interventions that could improve care engagement, such as providing and enhancing access to technology for health care engagement and remotely delivering social support and mental health services. Research on such potential interventions is needed for older, rural PLH.
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Affiliation(s)
- Andrew E. Petroll
- Health Intervention Sciences Group/Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Katherine G. Quinn
- Health Intervention Sciences Group/Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Steven A. John
- Health Intervention Sciences Group/Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Zack Nigogosyan
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jennifer L. Walsh
- Health Intervention Sciences Group/Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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12
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Idorenyin Imoh U, Charity T. Cultural and Social Factors in Care Delivery Among African American Caregivers of Persons With Dementia: A Scoping Review. Gerontol Geriatr Med 2023; 9:23337214231152002. [PMID: 36718247 PMCID: PMC9880147 DOI: 10.1177/23337214231152002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/01/2022] [Accepted: 12/28/2022] [Indexed: 01/26/2023] Open
Abstract
Cultural and social factors significantly influence the care provided to persons with dementia. This scoping review aimed to map emerging evidence on the influence of cultural and social factors on care delivery among Africa American caregivers of persons with dementia, especially during the COVID-19 pandemic. Using a systematic scoping review approach, we identified 21 studies on cultural and social factors influencing care delivery. The search included EMBASE, CINAHL, the Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, and Epistemonicos. A narrative synthesis of the data revealed that cultural and social factors greatly influence African American caregivers of persons with dementia and COVID-19 in care delivery, who perceive caregiving as a responsibility and not just a job. These caregivers are additionally guided by their racial identity and faith beliefs, integrating family values and culture into caregiving. African American caregivers showed compassion and resilient care selfperceptions. Supporting compassionate care delivery by African American caregivers requires an understanding of the social and cultural factors which drive their commitment to quality care for older adults with dementia in a pandemic environment.
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13
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Bonds Johnson K, Brewster GS, Cicero E, Hepburn K, Clevenger CK, Daniel G, Pak V, Paul S, Epps F. Promoting Caregiver Mastery in Black American Dementia Caregivers. THE GERONTOLOGIST 2022; 62:685-693. [PMID: 34610111 PMCID: PMC9154278 DOI: 10.1093/geront/gnab147] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Indexed: 11/13/2022] Open
Abstract
Over 6 million older Americans live with Alzheimer's disease and related dementias; Black American older adults' prevalence is more than twice that of non-Hispanic White older adults. The Black American dementia caregiving experience can be encapsulated within the Black Family Socioecological Context Model, which provides a conceptual basis for examining social determinants of health at individual, family, community, and societal levels with careful consideration for how the intersection of race, gender, and class of Black American dementia caregivers influences the multiple dimensions of their caregiving experiences. Family dynamics, community setting, and health care systems have a potentially bidirectional influence on these caregivers, which is shaped by historical and ongoing systemic and institutional racism and general disenfranchisement. This Forum article outlines how the Social Cognitive Theory offers ways for Black American dementia caregivers to achieve a sense of mastery within the complicated and fraught ecology within which their caregiving occurs. We propose a research agenda to create programs and interventions for enhancing a sense of mastery among Black American dementia caregivers. Two concepts in particular, "constraints" and "efficacy expectations," provide ways to create a systematic approach to developing successful coping strategies for the constraints perceived by individuals as they undertake and function in the caregiving role. The recognition of the complexity of the caregiving ecosystem and intersectionality of caregivers' experience and identity emphasize the importance of individualization: Each caregiver's experience of this ecosystem-and therefore each Black American dementia caregiver's way to mastery within it-will be uniquely shaped and experienced.
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Affiliation(s)
| | - Glenna S Brewster
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Ethan Cicero
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Carolyn K Clevenger
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Gaea Daniel
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Victoria Pak
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Sudeshna Paul
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Fayron Epps
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
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14
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Keller AO, Norris NC, Easter B, Garr A, Morgan G, Dicks-Williams R, Galambos C. A time for me: A virtual program to engage African American caregivers. J Women Aging 2022:1-14. [PMID: 35446750 DOI: 10.1080/08952841.2022.2064175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To address the self-care needs of African American family caregivers, a community-engaged approach was used to develop and implement a half-day virtual self-care program. This study evaluates experiences of program attendees. All attendees were emailed an electronic survey containing Likert-type and open-ended questions. Responses were examined for patterns and key content-related categories using inductive content analysis. Eleven attendees responded to the survey. All 11 strongly agreed (64%) or agreed (36%) that the event met their expectations and/or needs. In addition to providing opportunity to take time to engage in self-care, the event created a virtual space for women to focus on themselves. Women spoke about three distinct ways the event met their needs: (1) learning and trying new things, (2) access to resources, and (3) having a shared experience. These findings suggest that virtual programs may be used as an additional resource to support the health of African American women caregivers.
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Affiliation(s)
- Abiola O Keller
- College of Nursing, Marquette University, Milwaukee, WI, USA
| | - Nia C Norris
- Wisconsin Alzheimer's Institute Regional Milwaukee Office, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bashir Easter
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Gail Morgan
- Wisconsin Alzheimer's Institute Regional Milwaukee Office, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Colleen Galambos
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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15
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Estrada LV, Resendez J, Perez GA. The Role of National Paid Family and Medical Leave Policies in Promoting Health Equity for Older Adults and Their Caregivers. J Gerontol Nurs 2022; 48:5-10. [PMID: 35201922 PMCID: PMC9017763 DOI: 10.3928/00989134-20220209-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
More than 48 million unpaid family/friend caregivers in the United States provide care to older adults. This unpaid workforce provides essential support for family members or friends who have a serious, long-term illness or disability. However, family caregivers are often under supported, which contributes to negative health, economic, and psychological consequences. Despite the significant contributions of family caregivers, there are limited policy supports aimed at alleviating the hardships of care on this growing community. National paid family and medical leave policy in particular holds substantial potential to alleviate the compounding burdens faced by family caregivers and address systemic inequities that contribute to disproportionately poorer caregiving outcomes among historically marginalized older adults and their caregivers. The purpose of the current article is to provide an overview of the economic burdens and caregiving-related health disparities experienced by Black/African American and Hispanic/Latinx family caregivers and discuss the impact of paid leave policies on the overall health and well-being of older adults. We propose a "Call to Action" for gerontological nurses to work in partnership with transdisciplinary colleagues, stakeholders, and advocates to ensure all family care-givers have access to paid leave. [Journal of Gerontological Nursing, 48(3), 5-10.].
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Affiliation(s)
- Leah V. Estrada
- Center for Health Policy, Columbia University School of Nursing, 560 W. 168 Street, New York, NY
| | | | - G. Adriana Perez
- Leonard Davis Institute of Health Economics, University of Pennsylvania School of Nursing, Philadelphia, PA
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16
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Cothran FA, Chang E, Beckett L, Bidwell JT, Price CA, Gallagher-Thompson D. A Landscape of Subjective and Objective Stress in African-American Dementia Family Caregivers. West J Nurs Res 2022; 44:239-249. [PMID: 34865588 PMCID: PMC8908689 DOI: 10.1177/01939459211062956] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Stress is a significant part of daily life, and systemic social inequities, such as racism and discrimination, are well-established contributors of chronic stress for African Americans. Added exposure to the stress of caregiving may exacerbate adverse health outcomes. This secondary analysis describes subjective and objective stress in African American family caregivers, and relationships of subjective and objective stress to health outcomes. Baseline data from 142 African American dementia family caregivers from the "Great Village" study were described using means and frequencies; regression models and Pearson's correlation were used to examine associations between demographics, social determinants of health, and health outcomes. Mixed models were used to examine change and change variation in cortisol. Most caregivers had moderate degrees of stress. Stress was associated with sleep disruption and depressive symptoms, and discrimination appeared to be an independent contributor to depressive symptoms. This work provides a foundation for interpreting subjective and objective indicators of stress to tailor existing multicomponent interventions.
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Affiliation(s)
- Fawn A. Cothran
- Family Caregiving Institute at the Betty Irene Moore School of Nursing; University of California, Davis
| | - Emily Chang
- Department of Statistics; Department of Public Health Sciences, University of California, Davis
| | - Laurel Beckett
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis
| | - Julie T. Bidwell
- Family Caregiving Institute at the Betty Irene Moore School of Nursing; University of California, Davis
| | - Candice A. Price
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis
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17
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Bender AA, McIntosh RL, Sudduth S, Harris M, Tuckey K, Morgan JC, Jungerman JM, Cox A, Moore MA, Ingram B, Pier E, Johnson TM, Loring DW, Hepburn K, Medders L, Levey AI, Lah JJ, Hales CM. The Georgia Memory Net: Implementation of a statewide program to diagnose and treat Alzheimer's disease and related dementias. J Am Geriatr Soc 2022; 70:1257-1267. [PMID: 35133003 PMCID: PMC9306650 DOI: 10.1111/jgs.17690] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/07/2022] [Accepted: 01/16/2022] [Indexed: 12/04/2022]
Abstract
Objectives The number of people living with dementia is growing and most patients go years without receiving a specific diagnosis or support services, leading to suboptimal care, negative impacts on the quality of life, and increased costs of care. To address these gaps, the State of Georgia Department of Human Services collaborated with academic and community partners to create the Georgia Memory Net (GMN). Design GMN is a hub and spoke model partnered with Emory University's Cognitive Neurology Clinic and Emory Goizueta Alzheimer's Disease Research Center to provide training and support for best practices in diagnosis and management to Memory Assessment Clinics (MACs) throughout the state. Setting Communities across the State of Georgia. Participants GMN is a mix of academic and community providers, hospital systems, state and community agencies. Patients and families are evaluated at the MACs and connected to community services. Intervention A dedicated clinic workflow: primary care providers (PCPs) identify a memory problem and refer to the MACs for diagnostic evaluation; meeting with a community services educator, and development of a care plan. The patient is reconnected with the PCP for continuity of care. Measurements Initial metrics include numbers of unique patients, total patient visits, and referrals to state agency partners for community services. Results GMN established five MACs across Georgia with annual state funding. Partners at Emory University provided initial training; refined patient workflows for best practices; and provide ongoing support, guidance, and continuing education for MAC teams. Local PCPs and community services partners demonstrated strong engagement with the new model. Conclusions GMN is an innovative care model to improve access to accurate and timely diagnosis in patients with memory loss. GMN may help improve the quality of life for patients and families through preventive and early care.
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Affiliation(s)
- Alexis A Bender
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rebecca L McIntosh
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Michaela Harris
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kathy Tuckey
- Department of Neurology, Augusta University, Medical College of Georgia, Atlanta, Georgia, USA
| | - John C Morgan
- Department of Neurology, Augusta University, Medical College of Georgia, Atlanta, Georgia, USA
| | - Joanna M Jungerman
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Abby Cox
- Georgia Department of Human Services, Division of Aging Services, Atlanta, Georgia, USA
| | - Miranda A Moore
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bryshia Ingram
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ellyn Pier
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Theodore M Johnson
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David W Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Laura Medders
- Integrated Memory Care Clinic, Emory Healthcare, Atlanta, Georgia, USA
| | - Allan I Levey
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - James J Lah
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Chadwick M Hales
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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18
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Deskins BP, Letvak S, Kennedy-Malone L, Rowsey PJ, Bedini L, Rhew D. The Experiences of African American Male Caregivers. Healthcare (Basel) 2022; 10:healthcare10020252. [PMID: 35206867 PMCID: PMC8871800 DOI: 10.3390/healthcare10020252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
Aging of the population has led to an increasing number of caregivers. While research has been conducted on caregiver experiences, less is known about the experiences of African American males in the U.S. This qualitative descriptive study describes the experiences of 13 African American men who acted as caregivers to adult chronically ill or debilitated loved ones, the majority of whom provided care during the COVID-19 pandemic. The revised Sociocultural Stress and Coping Model (R-SSCM) guided this study. Individual interviews were conducted via the Zoom application. Content analysis revealed four themes: (1) “My time to take the reins”, (2) “It’s a male thang”, (3) “Caring amid a pandemic”, and (4) “Effects of the caregiver’s journey”. This study’s findings in relation to the literature provide overdue attention to the African American male caregiving experience, especially in relation to the COVID-19 pandemic. The implications of our findings include the need for more culturally congruent support services for African American male caregivers, as well as increased efforts to encourage trust in the healthcare system—especially in relation to vaccination for the SARS-CoV-2 virus.
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Affiliation(s)
| | - Susan Letvak
- School of Nursing, UNC Greensboro, Greensboro, NC 27402, USA; (L.K.-M.); (P.J.R.)
- Correspondence: ; Tel.: +1-336-256-1024
| | | | | | - Leandra Bedini
- School of Health and Human Sciences, UNC Greensboro, Greensboro, NC 27402, USA;
| | - Denise Rhew
- Cone Health, Greensboro, NC 27401, USA; (B.P.D.); (D.R.)
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19
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Shulyaev K, Gur-Yaish N, Shadmi E, Zisberg A. Patterns of informal family care during acute hospitalization of older adults from different ethno-cultural groups in Israel. Int J Equity Health 2020; 19:208. [PMID: 33225953 PMCID: PMC7682070 DOI: 10.1186/s12939-020-01314-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction Informal caregiving during hospitalization of older adults is significantly related to hospital processes and patient outcomes. Studies in home settings demonstrate that ethno-cultural background is related to various aspects of informal caregiving; however, this association in the hospital setting is insufficiently researched. Objectives Our study explore potential differences between ethno-cultural groups in the amount and kind of informal support they provide for older adults during hospitalization. Methods This research is a secondary data analysis of two cohort studies conducted in Israeli hospitals. Hospitalized older adults are divided into three groups: Israeli-born and veteran immigrant Jews, Arabs, and Jewish immigrants from the Former Soviet Union (FSU). Duration of caregiver visit, presence in hospital during night hours, type of support (using the Informal Caregiving for Hospitalized Older Adults scale) are assessed during hospitalization. Results are controlled by background parameters including functional Modified Barthel Index (MBI) and cognitive Short Portable Mental Status Questionnaire (SPMSQ) status, chronic morbidity (Charlson), and demographic characteristics. Results Informal caregivers of “FSU immigrants” stay fewer hours during the day in both cohorts, and provide less supervision of medical care in Study 2, than caregivers in the two other groups. Findings from Study 1 also suggest that informal caregivers of “Arab” older adults are more likely to stay during the night than caregivers in the two other groups. Conclusions Ethno-cultural groups differ in their patterns of caregiving of older adults during hospitalization. Health care professionals should be aware of these patterns and the cultural norms that are related to caregiving practices for better cooperation between informal and formal caregivers of older adults.
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Affiliation(s)
- Ksenya Shulyaev
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, Haifa University, Mt. Carmel, 3498838, Haifa, Israel.
| | - Nurit Gur-Yaish
- The Center for Research and Study of Aging, Faculty of Social Welfare and Health Science, Haifa University, Haifa, Israel.,Oranim Academic College of Education, Kiryat Tiv'on, Israel
| | - Efrat Shadmi
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, Haifa University, Mt. Carmel, 3498838, Haifa, Israel
| | - Anna Zisberg
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, Haifa University, Mt. Carmel, 3498838, Haifa, Israel
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20
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Sabo K, Chin E. Self-care needs and practices for the older adult caregiver: An integrative review. Geriatr Nurs 2020; 42:570-581. [PMID: 33160748 DOI: 10.1016/j.gerinurse.2020.10.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
Older adult caregivers experience health risks due to the demands of the role, higher prevalence of chronic illness, the aging process, and insufficient time for self-care. Using Whittermore and Knafl's methodology, an integrative review was conducted to explore the self-care needs and practices of older adult caregivers. The terms self-care, caregiver, informal caregiver, carer, family carer, and older adult were used to search the CINAHL, PsychINFO and SocIndex databases and obtain studies published in English between 2010 and 2020. Non-research articles, reviews, mean age of subjects < 50 years, studies focused on formal caregivers were excluded. Fifteen articles met inclusion criteria. Physical activity, stress management, social support, and support resources were identified as self-care needs. Self-care practices included self-advocacy, coping strategies, prioritizing of self, legacy building, and activism. Further exploration is required on how to best support older adult caregivers in fulfilling their caregiving role while promoting their own health.
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Affiliation(s)
- Kathryn Sabo
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02747, United States.
| | - Elizabeth Chin
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02747, United States.
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