Does Experience of Discrimination in Social and Health Care Settings Impact Satisfaction with Services Among Racial and Ethnic Minority Family Caregivers of Older Adult Relatives?

Background and Purpose: Receiving formal social support plays a pivotal role for family caregivers of older adult relatives with chronic illnesses. However, much literature on caregiving shows that immigrants and racial and ethnic minorities tend not to use social and health care services, and when they do they typically do not receive sufficient support from service providers. As a result, they tend to be dissatisfied with their experience using services. To find reasons for dissatisfaction with health care services, recent studies have focused on systemic barriers (i.e. discrimination) faced by minority family caregivers in the U.S. However, relatively little is known about the relationships between satisfaction with formal services and minority family caregivers’ experiences of discrimination by both social and health care agencies in Canada. The purpose of this study is to explore the effects of experiences of discrimination in social and health care settings and caregivers’ social locations on overall satisfaction with services amongst racial and ethnic minority family caregivers of older adult relatives.

Methods: A cross-sectional survey was conducted with 103 racial and ethnic minority family caregivers of older adult relatives residing in Montreal, Canada in 2017-2018. The sample was drawn from community and religious organizations, informal referrals, social service agencies-based service providers, on site recruitment by the researcher, flyers, and newsletters. By using SPSS 24, bivariate and hierarchical multiple regression were conducted.

Results: Among 103 participants, the majority of caregivers were female (70%), and spouses (43 %), had a mean age of 60, and had university level degrees (55.8%). Participants reported a high level of experience of discrimination in social and health care settings (M=3.72, SD=1.62; range 0-5). Results of the hierarchical regression analysis show that familiarity with the Canadian Social and Health care system and caregivers’ care burdens impacted overall satisfaction with social and health care services. After controlling for caregivers’ social location factors, experiences of discrimination in social and health care settings impacted overall satisfaction with services (F (7,94) =3.69, P<.00).

Conclusion and Implication: This findings of the study suggest the increased cultural competence of service providers is needed for racial and ethnic minority caregivers of older adults. Specifically, the culturally appropriate training can not only improve ability of service providers but also provide good quality of service for minority family caregivers who care for their loved ones with chronic illness at home.