Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Golden Gate (Hyatt Regency San Francisco)

Understanding Burden and Depression among Latino Caregivers in California: An Examination of Cultural Factors Impacting Family Caregivers of the Elderly

Steve Wilson, PhD, LCSW, California State University, Long Beach and Gokul S. Mandayam, PhD, University of Southern California.

Purpose: Factors associated with family caregiving have received considerable attention owing to an increase in the growing numbers of older adults who rely on family for long-term care. Cultural values and beliefs can strongly influence the perceptions of family caregiving as well as the propensity of caregivers to seek formal or informal interventions or support to address their own health and mental health needs. There is still limited comprehensive research on the perception of caregiver burden and depression as experienced by ethnic caregivers, most specifically Latinos, the largest ethnic population in California. Consequently the psychosocial, health, and mental health factors of Latino caregivers are still virtually unknown. This study provides the first extensive examination of Latino caregivers by presenting key similarities and differences in how family caregiving impacts Latino and European-American (White) caregivers.

Methods: Using comprehensive caregiver assessment data (N=14,620) extracted from eleven Caregiver Resource Centers throughout the State of California, the researchers compared characteristic differences between Latino (n=1,199) and White (n=9,707) caregivers. Assessment instruments included in the dataset were the Revised Memory and Behavior Checklist, ADL/IADL Scales, and the Center for Epidemiologic Studies Depression Scale. Findings were then compared to cultural family caregiving literature. Descriptive statistics provided the foundation for this study along with group comparisons on important caregiving dimensions. Finally, the study explored unique unmet caregiving needs and barriers as perceived by Latino caregivers.

Results: Latino caregivers were significantly younger than their White counterparts (54.6 vs. 61.6 years), more likely to be employed (32.6% vs. 21.4%), and in significantly poorer health (c2=61.533, p=.000). It was also found that compared to Whites, Latino caregivers were caring for family members with more behavior problems (t=3.363, p=.001) and were assisting family members with significantly more ADLs and IADLs. Not surprisingly, when compared to White caregivers, they felt significantly more burdened in their role (c2 = 33.479, p=.000) and more depressed (t=4.907, p=000) with over 50% of Latinos reflecting clinically significant depression levels. Within the Latino culture, the influence of family cannot be overstated; accordingly this sample showed significantly more hours of family/friend support than Whites (t=7.409, p=.000). Still, findings from this study revealed some important unmet areas for intervention which could help alleviate caregiver burden. Latinos showed significantly less knowledge about how and where to request help (c2 = 33.479, p=.000), how to manage difficult situations (c2 = 31.592, p=.000), how to manage stress, (c2 = 6.429, p=.040) and their perceived caregiving competency (c2 = 13.512, p=.001).

Implications: Given that White and Latino family caregivers demonstrated uniquely different patterns of caregiving burden and depression, and relied on formal sources of care differently, it is vital to consider ethnicity and culture variables when developing care plans with family caregivers. These study findings further emphasize the importance of developing culturally competent caregiving service delivery as well as agency initiatives and social policies to help improve the quality of life of Latino family caregivers as well as all ethnically and culturally diverse clients.