Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Family Caregiving with Older Adults

Exploring Family Caregiver Services: Variations in Utilization Patterns and Barriers to Access among Diverse Ethnic Groups

Purpose: Family caregivers are the main source of long-term care for older persons in the United States. Meanwhile, the caregiving situation exists in a context where cultural values and beliefs shape perceptions of the caregiving situation, determine who provides care within the family, and influence whether the caregiver will seek formal or informal intervention for instrumental or emotional support. However, little is known to what extent ethnic minority caregivers use services differently. This study examined patterns of service use, barriers to service access and levels of unmet needs for family caregiving services among ethnic populations.

Methods: We conducted telephone surveys of 1,643 randomly sampled respondents in California who provided care to someone age 50 or over. ANOVA and chi-square statistics were conducted to examine the quantity, types and sources (informal vs. formal) of services utilized by African American, Asian/Pacific Islander, Latino, and White caregivers. Unmet needs and service barriers experienced by the caregivers were compared across racial/ethnic groups. Post hoc analyses were conducted where main effects were significant.

Results: When formal and informal services were combined, there were significant ethnic differences in the types of services most likely sought by caregivers, as well as the total number of services used. The types of caregiver services most likely sought by African American caregivers included information, education, night respite, and legal services. Asian/Pacific Islanders, while less likely to use education services, were more likely using in-home respite and financial information. White caregivers were more likely using support group services. Before distinguishing whether services came from formal vs. informal sources, African American and White caregivers reported using the highest mean number of services while Hispanic and Asian/Pacific Islander caregivers reported the lowest means. When the source of each service type was compared by race/ethnicity, White caregivers were most likely to rely on formal services than other caregivers (χ²=23.680, p=0.001) for all service types, while Asian/Pacific Islander caregivers were least likely to rely on formal sources of respite than other caregivers. A higher proportion of ethnic caregivers reported having unmet needs than White (χ²=23.011, p=.001). Service barriers experienced differed somewhat by caregivers, in that African American caregivers were more likely to report service quality issues as a barrier (χ²=28.017, p=0.001), while Asian/Pacific Islander caregivers were more likely to report structural/system-level barriers, such as providers not speaking their language (χ²=37.474, p=0.000).

Implications: Family caregivers demonstrated different patterns of service use by ethnic groups, relying on formal and informal sources of care differently. More important, ethnic family caregivers reported higher level of unmet needs than White and identified structural and service barriers to access and use of services. Results from this study underscore the importance of developing culturally competent caregiver services, at all levels of the service delivery system, especially when working with ethnically and culturally diverse clients. Implications for research suggest the need for further understanding caregiver experiences not only by race/ethnicity, but also by the intersection of race/ethnicity and environmental or other characteristics within the caregiving situation.

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