Caregiving stress: Coping strategies among Latinos caring for older kin

Caregiving stress can adversely affect caregivers' well-being and compromise caregiving effectiveness. All family caregivers cross-culturally may be vulnerable to caregiving stress, although how it is experienced may vary (Aranda & Knight, 1997). Since culture influences how one copes with stress (Lazarus & Folkman, 1984), research on coping among Latino caregivers can help inform culturally responsive interventions for this population. Latino caregivers tend to have few socioeconomic resources and care for elders who are in poor health and economically disadvantaged. Consistent with their ethnocultural contexts, they often rely on fatalistic beliefs for coping (Falicov, 1998).

This study examined coping strategies previously identified by these researchers in focus groups with Latino caregivers. We tested three hypotheses: (1) caregiving is associated with high levels of physical and emotional distress; (2) caregivers who report higher physical and emotional distress report using fewer numbers of the coping strategies provided; (3) caregivers who report higher levels of acceptance of their role as caregivers report using fatalistic coping strategies.

We used a cross-sectional survey design. A convenient sample of Latinos/as providing care for ill or frail older relatives (N=321) was recruited through referrals, flyers, churches, and community based organizations. Respondents (142 men, 179 women), primarily married, median age 35-40 years, and low income (median $23,500) and education (42.4% finished high school) completed a questionnaire in English or Spanish.

The dependent variables were measured with two scales constructed as the average value of a series of rating scale questions. The independent variables were measured as the average scale from 12 coping strategies. We used two types of multivariate regressions. First, we treated the dependent variable as an ordinal variable and used ordinal regression. Second, we classified caregiver stress into high, medium, and low categories and used multinomial logistic regression. We compared the results from both methods.

As proposed in hypothesis 1, caregiving was associated with high levels of distress. Results did not support hypotheses 2 and 3. The higher the distress level, the significantly more likely caregivers were to utilize greater numbers of coping strategies; each one unit increase in the coping strategy score is significantly associated with 0.04 unit (p<0.001) increase in distress. Contrary to our expectation, caregivers with higher stress levels stemming from a sense of acceptance of their role as caregivers were significantly less likely to report using fatalistic coping strategies.

Family caregiving was perceived as stressful. Participants reported using several coping strategies, although those associated with fatalistic beliefs were not as common. Future research could explore the role of fatalism in coping, which this study suggests may not be as prevalent as in traditional Latino culture. The findings can help inform culturally responsive social work practice and program development.

Aranda, M. & Knight, B. (1997). The influence of ethnicity and culture on the caregiver stress-coping process: A sociocultural review and analysis. The Gerontologist 37 (3) 342-354.

Falicov, C. (1998). Latino Families in Therapy: A Guide to Multicultural Practice. NY: Guilford.

Lazarus, R. & Folkman, S (1984). Stress, appraisal, and coping. NY: Springer. .