Caregivers and Functioning Among Older Adult Mexican Migrants and Nonmigrants
A significant proportion of older Mexican residents are return-migrants who worked and resided in the United States and are unlikely to receive publicly-provided pensions and healthcare benefits in their old age. Therefore, they have to rely on family for the provision of health-related care. Despite a consistent finding that females are the primary source of non-financial support for aging people in Mexico, it remains unclear how caregiving may differ in terms of the capacity of support networks to provide care, and how sex of caregiver is associated with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) in the later life of previously unimpairedaging return migrants and non-migrants. It is important to determine whether family supports provide viable mechanisms by examining whether or not having a potential female caregiver in the household was predictive of future ADLs or IADLs.
Methods:
Data come from the 2001-2012 waves of the Mexican Health and Aging Study (MHAS), a panel study representative of the non-institutionalized population aged 50 and over. The analytic sample consists of 13,363 individuals. Although the MHAS has contains many measures of health status, this study was restricted to ADLs and IADSs. To fully exploit the MHAS panel, the study design incorporates longitudinal analysis methods. We looked at ADL and IADL deficiencies in 2003 and 2012 for persons without these deficiencies in 2001. A potential female caregiver was defined as a daughter, daughter-in-law or another female in the household (e.g., sister or grandchild) between the ages of 18 and 59.
Results:
Among all households, 56% had a potential female caregiver, with 80% of these households having a biological daughter present. We found that for non-migrant Mexicans, the presence or absence of a potential female caregiver in 2001 made no difference in future ADL or IADL status. However, controlling for age and sex, migrants with no potential female caregiver in 2001 were less likely to have ADL/IADL deficiencies in 2003 and 2012 than nonmigrants (with or without a potential female caregiver). Odds ratios were 0.4-0.7 and were statistically significant. On the hand, migrants with potential female caregivers in 2001 were more likely than nonmigrants to experience difficulties with ADLs/IADLs. Odds ratios were 1.8-3.3 and were statistically significant for both future years and both classes of deficiencies.
Conclusions and Implications:
This study explored the interplay of caregiving availability and source, and examined its association with IADL and ADL status over time among return migrants and non-migrant Mexicans. Our results suggest that return migrants who suffer from ADL and IADL deficiencies may have anticipated their health declines and sought out a female caregiver in family. While family support remains the cornerstone of care for Mexico's return migrants, recent findings on increased family disruption among migrants coupled with the secular trend of decreasing family size raise the prospect of insufficient availability of family support for this population. The findings have implications for coordinating family support with public programs like home assistance or nursing services.