Psychological Well-Being and Self-Rated Health Among Caregivers of Older Adults: Does Nativity Status of Care Recipient Matter?

Background and Purpose:

In 2010, there were nearly 40,000 foreign born older adults in the U.S., most of whom will receive care from family members. Caregiver (CG) responsibilities range from assisting with basic activities to delivering healthcare. Family CGs are often unpaid and without training, and may experience negative physical and mental health effects. However, there is a paucity of research on CGs of foreign born care recipients (CRs). The aim of this study was to explore how the experiences of CGs of foreign born CRs may be unique in comparison to CGs of U.S. born CRs. Based on existing studies and the Stress Process Model (SPM), we hypothesized that relative to CGs of U.S. born CRs, CGs of foreign born CRs would report poorer self-rated physical health and psychological well-being. We also hypothesized that racial and ethnic minority status will have a significant interaction effect with CR nativity status, which moderates self-rated physical health and psychological well-being among CGs.

 

Methods:

This study utilizes data from Round 1 (2011) of the National Health and Aging Trends Study and the National Study of Caregiving to identify community-dwelling CRs and their CGs (N=1,293). Measures used included demographics, stressors, resources, and outcomes (self-rated physical health and psychological well-being) as guided by SPM. Independent t-tests and chi-square tests were used to assess differences between CGs of U.S. born and foreign-born CRs on a variety of demographics and chronic conditions. OLS regression analyses were used to investigate factors, in particular, immigrant status and race/ethnicity, as well as their interactions and association with CGs’ psychological well-being and self-rated physical health.

 

Results:

Significant differences between CG groups included that CGs of foreign born CRs had higher income, were less likely to be someone other than family, were less likely to have arthritis, and more likely to have osteoporosis. CGs who provided care for foreign born CRs reported significantly lower psychological well-being compared to CGs of U.S. born CRs. However, those CGs who provided care for foreign born CRs reported significantly better physical health. CGs of foreign born Hispanic and Black CRs were more likely to report better psychological well- being compared to CGs of White foreign born CRs.  Compared to CGs of White foreign born CRs, CGs of Black foreign born CRs showed better physical health, but CGs of Hispanic foreign born CRs showed worse self-rate physical health.

Conclusions and Implications:

Our results yield critical information on the identification of risk factors for CGs of foreign born CRs.  It is possible that the lack of CR resources and other cultural barriers may impact the lower level of psychosocial well-being observed among CGs of foreign born CRs.  Also, CGs of foreign born Hispanic CRs showed poorer self-ratedhealth than other CG groups. As such, this group of CGs may be the most vulnerable to poor health outcomes and should be considered for future research as well as tailored practice interventions.