Outcomes of a Pilot Study of African American Dementia Caregivers With Depressive Symptoms: Perceptions of Depression and the Influence of Culture On Caregiving
Background and Purpose: This study describes the presence and meaning of depressive symptoms and signs in African American dementia caregivers. While certain coping types are commonly used when caregiving, African American women use emotion-focused caregiving often (Chadiha, et al, 2004). Escapism, passive response, prayer, or no response characterize this type of coping, but may cause psychological distress. It is believed that African Americans may not experience feelings of burden as early as other groups due to extended family networks and shared caregiving roles (Morycz, Malloy, Bozich, & Martz, 2008). Specific interventions to enhance coping skills and help African Americans understand their caregiving limitations may help to reduce feelings of perceived failure in meeting role expectations (Cox, 1995). Some information is known about the ways in which African Americans make meaning of their caregiving roles and responsibilities. What is lesser known is the depth of the psychological and physical effects of caregiving on the African American caregiver, including how this is described and understood by the individual.
Methods: A purposive sample of African American dementia caregivers was interviewed. In-depth semi-structured interviews were conducted with 25 male and female adults aged 50 and older who scored five or higher on the Geriatric Depression Scale Short Form. Interviews were audio-recorded with participant consent. The transcriptions of these interviews were analyzed using standard qualitative methods including data review, large-level sorting, and coding for themes and patterns (Black, Gitlin, & Burke, 2011). All data for each theme was gleamed from each participant’s individual explanations of depressive signs and symptoms. In the second phase of data analysis more detailed analysis of transcripts included coding for sub-themes related to depressive signs and symptoms. Each participant’s interview contextualized African American dementia caregivers’ conceptualization of depression (Black, White, & Hannum, 2007).
Results: The analyses yielded descriptive information about how African American dementia caregivers perceived depression and the influence of culture on caregiving. Common perceptions of depression included: anger, fear, lack of protection from outside forces, and uncertainty. Culture influenced caregiving by recognizing the importance of family for caregiving support, seeking help from others based on informal referrals, and seeking help from outside sources in order to maintain employment. Caregivers expressed a lack of support from family members and feelings of frustration with the inability to take part in personally meaningful activities while juggling the role of caregiver.
Conclusions and Implications: This pilot study provides information for social workers that are or will work with African American dementia caregivers. The identification of caregivers’ lack of consistent support from family members challenges the accepted construct of African American kinship networks and strong filial obligations. Findings from this study highlight the importance for extended outreach to African American dementia caregivers that assists with psychoeducation, concrete services, and respite alternatives. This study also offers suggestions for programs that would be useful to dementia caregivers to provide additional supports for mental health counseling.