Racial Differences in Social Support, Social Activity, and Service Utilization Among Family Caregivers of People with Alzheimer's Disease

Background and Purpose. Family caregivers are becoming more common as the aging population rises and, consequently, the number of individuals experiencing Alzheimer’s disease rises. Caregivers from different cultures face different barriers in receiving the help they need, as different cultures view and experience caregiving differently. The present study aimed to examine whether there are racial/ethnic group differences in service utilization, social support, and social activity among caregivers of older adults with Alzheimer’s disease, and whether these factors affect the caregiving (i.e., frustrations with caregiving and quality of caregiving) they provide to older adults.

Methods. This study was a cross-sectional analysis of baseline data from the Resources for Enhancing Alzheimer’s Caregiver Health (REACH II) study. The REACH II data was gathered through in person interviews. The multi-ethnic sample consisted of 670 caregivers of older adults with Alzheimer’s disease and included 217 African Americans/Blacks, 226 Hispanics/Latinos, and 227 Caucasians/Whites. Social support was measured by eleven four-point Likert scale questions and four six-point Likert scale questions (α=.84). Social activity was measured by seven questions rated on a three-point Likert scale (α=.78). Service utilization was measured by seven questions in the Formal Care and Services form and the internal consistency reliability analysis was not examined due to the nature of the service utilization variable. Frustrations with caregiving and quality of caregiving were both measured on a four-point Likert scale and included seventeen questions for quality of caregiving (α =.82) and nine items for frustrations of caregiving (α =.56). A series of one-way ANOVA and multiple linear regression analyses were conducted. Caregiver income, age, and gender were included as covariates in the regression models.

Results. The results of ANOVA tests demonstrated that there were significant racial/ethnic group differences in social support, social activity, and service utilization. The study results revealed that caregivers who were White and Hispanic had significantly lower service utilization than caregivers who were Black. Caregivers who were Hispanic had both significantly lower social support and social activity than White and Black caregivers. The results of a regression analysis showed that social support significantly enhances quality of caregiving provided to older adults with Alzheimer’s disease. However, social support, social activity, and service utilization did not significantly predict frustrations with caregiving among caregivers.

Conclusion and Implications. There is currently little existing support for family caregivers, so it is necessary to continue to develop programs to provide these services. As this population continues to grow it will become an increasing problem, so social workers must advocate for more research on family caregivers and more funding for programs helping this population. The current study’s findings demonstrate that it is necessary to develop services to help Hispanic caregivers develop and grow their social supports, as they were found to have lower levels of social support. This is important because social support was found to be a significant predictor of higher quality caregiving. Society must take care of and support family caregivers so that they can provide the best quality of care possible to their loved ones.