Familismo and Its Impact on the Family Caregiving of Latinos With Alzheimer’s Disease

Abstract

Despite the long-held view that Latinos’ value and reliance on family leads to greater involvement of extended family in caring for sick members and reduced perception of burden, some research reports low levels of social support and high levels of distress among Latino caregivers. We explore this seeming discrepancy in a qualitative study of 41 Latino caregivers of family members with Alzheimer’s disease, interviewing them regarding the role of familism in their caregiving experience. For some it facilitates caregiving in the traditional, expected manner. Other caregivers disavow its current relevance. Yet others feel a contrast between familism, which they may value in a general, abstract way and more personal, immediate negative feelings they are experiencing from caregiving. We discuss these complex, multidimensional findings, the variation among caregivers, and present implications for practice, policy, and research.

Keywords

Latinos caregivers familism Alzheimer’s disease cultural values

Get full access to this article

View all access options for this article.

References

Abell

(2001). Assessing willingness to care for persons with AIDS: Validation of a new measure. Research on Social Work Practice, 11, 118–130.

Adams

Aranda

Kemp

Takagi

(2002). Ethnic and gender differences in distress among Anglo American, African American, Japanese American, and Mexican American spousal caregivers of persons with dementia. Journal of Clinical Geropsychology, 8, 279–301.

Andrews

J. W.

Lyons

Rowland

(1992). Life satisfaction and peace of mind: A comparative analysis of elderly Hispanic and other elderly Americans. Clinical Gerontologist, 11, 21–42.

Angel

J. L.

Angel

R. J.

Aranda

M. P.

Miles

T. P.

(2004). Can the family still cope? Social support and health as determinants of nursing home use in the older Mexican-origin population. Journal of Aging and Health, 16, 338–354.

Angel

R. J.

Angel

J. L.

Himes

C. L.

(1992). Minority group status, health transitions, and community living arrangements among the elderly. Research on Aging, 14, 496–521.

Aranda

M. P.

Knight

B. G.

(1997). The influence of ethnicity and culture on the caregiver stress and coping process: A sociocultural review and analysis. The Gerontologist, 37, 342–354.

Archbold

P. G.

Stewart

B. J.

Greenlick

M. R.

Harvath

(1990). Mutuality and preparedness as predictors of caregiver role strain. Research in Nursing & Health, 13, 375–384.

Bedard

Molloy

D. W.

Squire

Dubois

Lever

J. A.

O’Donnell

(2001). The Zarit Burden interview: A new shorter version and screening version. The Gerontologist, 41, 652–657.

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.

10.

Burnette

(1999). Custodial grandparent in Latino families: Patterns of service use and predictors of unmet needs. Social Work, 44, 22–34.

11.

Chase

S. E.

(2003). Learning to listen: Narrative principles in a qualitative research methods course. In Josselson

Lieblich

McAdams

D. P.

(Eds.), Up close and personal: The teaching and learning of narrative research (3rd ed., pp. 79–99). Washington, DC: American Psychological Association.

12.

Cohen

Kamarck

Marmelstein

(1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.

13.

Coon

D. W.

Rubert

Solano

Mausbach

Kraemer

Arguelles

Haley

W. E.

Thompson

L. W.

Gallagher-Thompson

(2004). Well-being, appraisal, and coping in Latina and Caucasian female dementia caregivers: Findings from the REACH study. Aging in Mental Health, 8, 330–345.

14.

Cox

Monk

(1990). Minority caregivers of dementia victims: A comparison of Black and Hispanic families. Journal of Applied Gerontology, 9, 340–354.

15.

Cox

Monk

(1993). Hispanic culture and family care of Alzheimer’s patients. Health and Social Work, 18, 92–103.

16.

Cox

Monk

(1996). Strain among caregivers: Comparing the experiences of African American and Hispanic caregivers of Alzheimer’s relatives. International Journal of Aging and Human Development, 43, 93–105.

17.

Depp

Sorocco

Kasl-Godley

Thompson

Rabinowitz

Gallagher-Thompson

(2005). Caregivers self-efficacy, ethnicity, and kinship differences in dementia caregivers. American Journal of Geriatric Psychiatry, 13, 787–794.

18.

Dilworth-Anderson

Goodwin

P. Y.

Williams

S. W.

(2004). Can culture help explain the physical health effects of caregiving over time among African American caregivers? Journal of Gerontology: Social Sciences, 59B, S138–S145.

19.

Federal Interagency Forum on Aging-related Statistics. (2010). Older Americans 2010: Key indicators of well-being. Hyattsville, MD: Author.

20.

Harwood

D. G.

Barker

W. W.

Cantillon

Loewenstein

D. A.

Ownby

Duara

(1998). Depressive symptomatology in first-degree family caregivers of Alzheimer disease patients: A cross-ethnic comparison. Alzheimer Disease and Associated Disorders, 12, 340–346.

21.

Jette

A. M.

Crawford

S. L.

Tennstedt

S. L.

(1996). Toward understanding ethnic differences in late-life disability. Research on Aging, 18, 292–309.

22.

Janevic

M. R.

Connell

C. M.

(2001). Racial, ethnic, and cultural differences in the dementia caregiving experience: Recent findings. The Gerontologist, 41, 334–347.

23.

John

McMillan

(1998). Exploring caregiver burden among Mexican-Americans: Cultural prescriptions, family dilemmas. Journal of Aging and Ethnicity, 1, 93–111.

24.

John

Resendiz

De Vargas

L. W.

(1997). Beyond familism?: Familism as explicit motive for eldercare among Mexican American caregivers. Journal of Cross-Cultural Gerontology, 12, 145–162.

25.

Kim

Knight

B. G.

Flynn Longmire

C. V.

(2007). The role of familism values in stress and coping processes among African American and White dementia caregivers: Effects on mental and physical health. Health Psychology, 26, 564–576.

26.

Knight

B. G.

Robinson

G. S.

Flynn Longmire

C. V.

Chun

Nakao

Kim

(2002). Cross cultural issues in caregiving for dementia: Do familism values reduce burden and distress? Ageing International, 27, 70–93.

27.

Knight

B. G.

Sayegh

(2010). Cultural values and caregiving: The updated Sociocultural Stress and Coping Model. Journal of Gerontology Psychological Sciences, 65B, 5–13.

28.

Koerner

S. S.

Shirai

(2012). The negative impact of global perceptions of and daily care-related family conflict on Hispanic caregivers: Familism as a potential moderator. Aging & Mental Health, 16, 486–499.

29.

Llanque

S. M.

Enriquez

(2012). Interventions for Hispanic caregivers of patients with dementia: A review of the literature. American Journal of Alzheimer’s Disease and Other Dementias, 27, 23–32.

30.

Losada

Marquez-Gonzalez

Knight

B. G.

Yanguas

Sayegh

Romero-Moreno

(2010). Psychosocial factors and caregivers’ distress: Effects of familism and dysfunctional thoughts. Aging & Mental Health, 14, 193–202.

31.

Losada

Robinson-Shurgot

Knight

B. G.

Marquez

Montorio

Izal

Ruiz

M. A.

(2006). Cross-cultural study comparing the association of familism with burden and depressive symptoms in two samples of Hispanic dementia caregivers. Aging and Mental Health, 10, 69–76.

32.

Lubben

Gironda

(2000). Social support networks. In Osterweil

Brummel-Smith

Beck

(Eds.), Comprehensive geriatric assessment (pp. 121–137). Westport, CT: Greenwood.

33.

Marks

N. F.

Lambert

J. D.

Jun

Song

(2008). Psychosocial moderators of the effects of transitioning into filial caregiving on mental and physical health. Research on Aging, 30, 358–389.

34.

Mausbach

B. T.

Coon

D. W.

Depp

Rabinowitz

Y. G.

Wilson-Arias

Kraemer

H. C.

Thompson

L. W.

Lane

Gallagher-Thompson

(2004). Ethnicity and time to institutionalization of dementia patients: A comparison of Latino and Caucasian female family caregivers. Journal of the American Geriatrics Society, 52, 1077–1084.

35.

Mittelman

M. S.

Ferris

Steinberg

Shulman

Mackell

Ambinder

Cohen

(1993). An intervention that delays institutionalization of Alzheimer’s disease patients: Treatment of spouse-caregivers. The Gerontologist, 33, 730–740.

36.

National Alliance for Caregiving/American Association of Retired Persons. (1997). Family caregiving in the U.S.: Findings from a national survey. Washington, DC: Author.

37.

Ortíz

Simmons

Hinton

W. L.

(1999). Locations of remorse and homelands of resilience: Notes on grief and sense of loss of place of Latino and Irish-American caregivers of demented elders. Culture, Medicine and Psychiatry, 23, 477–500.

38.

Ortíz

Fitten

L. J.

(2000). Barriers to healthcare access for cognitively impaired older Hispanics. Alzheimer Disease and Associated Disorders, 14, 141–150.

39.

Ory

Yee

J. L.

Tennstedt

Shulz

(2000). The extent and impact of dementia care: Unique challenges faced by family caregivers. In Schulz

(Ed.), Handbook on Dementia Caregiving (pp. 1–32). New York, NY: Springer.

40.

Parrott

T. M.

Bengtson

V. L.

(1999) The effects of earlier intergenerational affection, normative expectations, and family conflict on contemporary exchanges of help and support. Research on Aging, 21, 73–105.

41.

Pearlin

L. I.

Mullin

J. T.

Semple

S. J.

Skaff

M. M.

(1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583–594.

42.

Pinquart

Sörensen

(2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18, 250–267.

43.

Polich

Gallagher-Thompson

(1997). Preliminary study investigating psychological distress among female Hispanic caregivers. Journal of Clinical Geropsychology, 3, 1–15.

44.

Radloff

(1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

45.

Reisberg

Ferris

S. H.

de Leon

M. J.

Crook

(1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 1136–1139.

46.

Reissman

C. K.

(1993). Narrative analysis. Newbury Park, CA: Sage.

47.

Reissman

C. K.

(2003). Narrative analysis. In Lewis-Beck

M. S.

Bryman

Futing Liao

(Eds.), The Sage encyclopedia of social science research methods. Thousand Oaks, CA: Sage.

48.

Rosenthal Gelman

(2010). “La lucha”: The experience of Latino family caregivers of patients with Alzheimer's disease. Clinical Gerontologist, 33(3), 181–193.

49.

Rozario

P. A.

Derienzis

(2008). Familism beliefs and pscyholgoical distress among Afrtican American women caregivers. The Gerontologist, 48, 772–780.

50.

Sabogal

Marin

Otero-Sabogal

Marin

B. V. O.

Perez-Stable

E. J.

(1987). Hispanic familism and acculturation: What changes and what doesn’t? Hispanic Journal of Behavioral Sciences, 9, 397–412.

51.

Scharlach

A. E.

Kellam

Ong

Baskin

Goldstein

Fox

P. J.

(2006). Cultural attitudes and caregiver service use: Lessons from focus groups with racially and ethnically diverse family caregivers. Journal of Gerontological Social Work, 47, 133–156.

52.

Shurgot

G. R.

Knight

B. G.

(2004). Preliminary study investigating acculturation, cultural values, and psychological distress in Latino caregivers of dementia patients. Journal of Mental Health and Aging, 10, 183–194.

53.

Silverstein

Parrott

T. M.

(2001). Attitudes toward government policies that assist informal caregivers: The link between personal troubles and public issues. Research on Aging, 23, 349–374.

54.

Szapocznik

Scopetta

M. A.

Kurtines

(1978). Theory and measurement of acculturation. Interamerican Journal of Psychology, 12, 113–130.

55.

Tennstedt

S. L.

Chang

Delgado

(1998). Patterns of long-term care: A comparison of Puerto Rican, African-American, and non-Latino White elders. Journal of Gerontological Social Work, 30, 179–199.

56.

U. S. Census Bureau. (2010). Census 2010. Washington, DC: Author.

57.

Valle

Yamada

A. M.

Barrio

(2004). Ethnic differences in social network help-seeking strategies among Latino and Euro-American dementia caregivers. Aging & Mental Health, 8, 535–543.