Orientation to the Caregiver Role Among Latinas of Mexican Origin

Exploring the Role of Marianismo and Loneliness in Latinas' Physical and Mental Well-Being

The goal of this study is to better understand the role of social relationships and traditional gender norms in Latina health. Utilizing Hawkley and Cacioppo's theoretical model of loneliness and health as a framework, loneliness is proposed as a key component in the relationship between the Latina gender norm of marianismo and health. Participants were 178 female adults who identified as Latina (N = 97) or non-Latina White (N = 81), ranging in age from 19-88, who completed measures of loneliness, marianismo, depression, overall health, and health practices. Results indicate that being Latina was associated with family pillar marianismo, which includes characteristics centered on women's roles as the core of the family, that was associated with lower loneliness, and lower loneliness was subsequently associated with better overall health, lower depression, and beneficial health practices. However, being Latina had no association with silencing self to maintain harmony marianismo, that in turn had no association with loneliness, or health outcomes. These results suggest that elements of marianismo can play a protective role in Latina health and well-being, particularly when Latinas endorse the positive aspects of the gender norm that place women at the center of their families. Results also help explain the Latino health paradox by providing more specificity in the links between Latina ethnicity and positive health outcomes.

“The Impact of Demographic Change on Transfers of Care and Associated Well-being”

This study aims to evaluate the impact of demographic change on long-term, macro-level childcare and adult care transfers, accounting for the associated well-being effects of informal caregiving. We measure the impact of demographic change on non-monetary care exchanged between different groups by estimating matrices of time transfers by age and sex, and weighting the time flows by self-reported indicators of well-being, for activities related to childcare and adult care. The analysis employs cross-sectional data from the American Time Use Survey 2011–2013, and the Panel Study of Income Dynamics, Disability, and Use of Time Module 2013 to produce the estimates of well-being associated with the two forms of care and their future projections. Both men and women experience more positive feelings when caring for children than when caring for adults. As a whole, caregiving is an overwhelmingly more positive experience than it is negative across both genders and care types. Yet women often report more tiredness and stress than men when providing childcare, while also experiencing more pain while performing adult care, as compared to childcare activities. Women of reproductive ages spend double the amount of care time associated with negative feelings, relative to men, most of which is spent on early childcare. We project a progressively widening gender gap in terms of positive feelings related to care in the coming decades. Future reductions in absolute caregiver well-being influenced by demographic changes at the population level may reduce workforce participation, productivity, and adversely impact psycho-physical condition of caregivers, if not offset by targeted policies.

Family Connections and the Latino Health Paradox: Exploring the Mediating Role of Loneliness in the Relationships Between the Latina/o Cultural Value of Familism and Health

This study aims to understand Latina/o health from a social relationships perspective. Specifically, a major goal of the study is to explain how despite disadvantages (e.g., lower income and less education), Latinas/os in some cases have superior health compared to non-Latina/o whites, a phenomenon known as the Latino Health Paradox. Based on the central role of familial relationships in Latina/o culture, and utilizing Hawkley and Cacioppo's theoretical model of loneliness and health as a foundation for the study, the premise underlying this research is that the Latina/o cultural value of familism has a beneficial impact on health via reduced loneliness. Participants were 255 adults who identified as Latina/o (N = 139) or non-Latina/o white (N = 116), ranging in age from 19-88. Results indicate that being Latina/o predicted strong endorsement of familism, that predicted lower loneliness, and lower loneliness subsequently predicted better overall health, mental health, and health practices. These results suggest that the cultural value of familism provides health-related benefits for Latinas/os, which contributes to understanding the Latino health paradox. Results also underscore the value of including loneliness in studies examining the impact of cultural values on health, as only loneliness had statistically significant direct associations with all three health outcomes.

Care v. Caring: Obligation, Duty, and Love Among Latino Alzheimer's Family Caregivers

The number of Latinos living with Alzheimer's disease is projected to grow. Latinos currently make one-fifth of U.S. family caregivers. In this paper, we explore the cultural scripts and gendered practice of care in Latino families in relation to the underutilization of services to persons with Alzheimer's disease and related dementias. We conducted interviews with 24 Latino caregivers in Miami-Dade, Florida representing six Latin American countries of origin. Interviews were analyzed using a grounded theory approach. We critically examined the concept of familism in order to better understand in-depth experiences of diverse Latino caregivers and concluded that an ethics of care model better elucidates the complexities of the care experience. Our analysis illustrates the ambivalence, contradictions, and changes in the beliefs and practice of care. These findings can help advance understanding among researchers and providers to develop a formal support system that is responsive to Latino caregiver needs.

The Experience of Alzheimer's Disease Family Caregivers in a Latino Community: Expectations and incongruences in support services

OBJECTIVES

Current theoretical constructs on the utilization of formal support for Latino caregivers focus on familism and exclude the cultural values represented in the service system. The purpose of this paper is to highlight the experience of care for Latino family caregivers to persons with Alzheimer's disease and related dementias (ADRD). We also examine the cultural congruence between provider perspectives with the expectations of Latino ADRD caregivers.

METHOD

We conducted extended interviews with 24 Latino ADRD caregivers and 10 service providers. Interview transcripts were coded and analyzed using a grounded theory approach.

RESULTS

Our study provides a deeper understanding of Latino caregiving experiences and highlights some of the structural and systematic issues in current systems of caregiver support. While Latino families have very specific notions of care, by upholding notions of familism, there is a tendency to not look deeper into how they may be better supported in caregiving and fall into the "culture trap." The assumption that family should be the natural support network for older adults may lead to health and social systems of care to ignore the specific needs of the Latino population.

DISCUSSION

Services are being provided under a model that was established four decades ago and may not reflect current realities. The concept of "an ethics of care" allows us to move beyond familism and explain that underutilization of services may also be due in part to the cultural incongruence between what service providers offer and the perceived needs of Latino caregivers.

Sources of Caregiving Burden in Middle-Aged and Older Latino Caregivers

OBJECTIVE

We aimed to identify sources of caregiver burden in middle-aged and older Latino caregivers of people with Alzheimer disease and related dementia (ADRD).

METHODS

Participants were recruited through an agreement with the Rush Alzheimer's Disease Center Clinic Data Repository. We conducted semistructured interviews with 16 middle-aged and older Latinos who were the primary caregiver for a family member diagnosed with ADRD. The interview guide consisted of questions and probes to capture participants' perceptions of family caregiving. Direct content analysis was performed.

RESULTS

Participants were aged 50 to 75 years (n = 16) and a majority female (n = 12). The sources of burden identified were (1) caregiver responsibilities, (2) caregiving-related health decline, (3) lack of support, (4) financial status, (5) vigilance, and (6) concerns about the future.

CONCLUSIONS

The influence of gender roles seemed to play a role in caregivers' perceptions of sources of burden, especially on caregiver responsibilities and perceptions of lack of support. Latinos cultural values such as familismo and marianismo likely reinforced gender disparities in family caregiving.

Differences within Differences: Gender Inequalities in Caregiving Intensity Vary by Race and Ethnicity in Informal Caregivers

Among the 50+ million informal caregivers in the US, substantial gender, racial/ethnic, and socioeconomic disparities in caregiving intensity are well-documented. However, those disparities may be more nuanced: gender disparities in caregiving intensity may vary by race/ethnicity (White, Black, and Hispanic) and socioeconomic status (SES). We used data from the 2011 National Study of Caregiving and applied generalized linear models to estimate associations between three measures of caregiver intensity (ADLs, IADLs, and hours caregiving/month) and the three sociodemographic factors with their interaction terms. Black female caregivers provided significantly higher levels of care than White females and males for both IADL caregiving and hours/month spent caregiving. Black caregivers spent an average of 28.5 more hours/month (95%CI 1.7-45.2) caregiving than White caregivers. These findings highlight the need to understand the complex disparities within population subgroups and how intersections between gender, race/ethnicity, and SES can be used to develop effective policies to reduce disparities and improve caregiver quality-of-life.

Transfers of informal care time in the United States: the role of demographic differentials in intergenerational flows by age, sex, and racial and national background

Recent work based on the American Time Use Survey (2011-2013) provided estimates of matrices of "who provides care to whom" by age and sex within care activities in the U.S. In this paper, we build on that line of research by evaluating the strength of race, ethnicity, and national origin as proxy indicators of cultural propensities to engage in informal care. Our results point to several key differences and similarities between groups based on their characteristics. For example, we find that compared to other groups, native-born African American men exhibit the lowest child care participation and transfer rates, whereas foreign-born Hispanics of any race have significantly higher rates of daily participation in child care. Moreover, we find that the propensity to provide adult care is largely dependent on socio-economic characteristics and household structure. However, our models indicate that neither race/ethnicity nor nativity are strong predictors of the observed differences when household composition and socio-economic factors are taken into account. Thus, we believe that more complex cultural factors are at play. As an illustrative example of the consequences of demographic change, we introduce the care support ratio (CSR), which is a measure of macro-level dependency for non-market transfers. The application of the CSR indicates that future informal care time deficits may result from the growing care needs of the ageing population.