Hispanic Caregivers of the Money Follows the Person Program in Connecticut: Satisfaction,Familism,and Burden

Abstract

Hispanic caregivers provide more assistance than the U.S. average, but underutilize support services and report low levels of program satisfaction. A possible exception is the Money Follows the Person (MFP) program. Using an ordered logit statistical approach, we studied program satisfaction of all Hispanic caregivers assisting Connecticut MFP participants from 2014 to 2019, examining the effects of caregiver familism, burden, and personal characteristics including self-reported health and perceived financial situation. Healthier caregivers with positive perceptions of MFP’s usefulness and lower subjective burden reported higher program satisfaction. In ordered logits for separate blocks, familism elements (finding caregiving worthwhile, feeling well-supported as a caregiver, and having a good relationship with the care recipient) were statistically significant and associated with higher satisfaction. Our exclusive focus on Hispanic caregivers highlights the role of familism in satisfaction, and demonstrates that programs with a supportive caregiver component can supplement familism ties and overcome barriers to service usage.

Keywords

Hispanic caregivers caregiving program satisfaction family caregiving familism Money Follows the Person program

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References

AARP, NAC. (2020). Caregiving in the U.S. https://www.caregiving.org/caregiving-in-the-us-2020/

Angel

R. J.

Angel

J. L.

(2015). Latinos in an Aging World. Social, Psychological, and Economic Perspectives. Routledge, Taylor & Francis.

Anthony

K. P.

Geldhof

J. G.

Mendez-Luck

C. A.

(2017). Characterizing caregiving intensity among Mexican-origin women caregivers. The Gerontologist, 57(6), 1084–1092. https://doi.org/10.1093/geront/gnw090

AP-NORC. (2018). The long-term care poll. https://www.longtermcarepoll.org/

Ayalong

(2004). Cultural variants of caregiving or the culture of caregiving. Journal of Cultural Diversity, 11(4), 131–138.

Balcazar

A. J.

Grineski

S. E.

Collins

T. W.

(2015). The durability of immigration-related barriers to health care access for Hispanics across generations. Hispanic Journal of Behavioral Sciences, 37(1), 118–135. https://doi.org/10.1177/0739986314567074

Balducci

Mnich

McKee

Lamora

Beckmann

Krevers

Wojszel

Nolan

Prouskas

Bien

Oberg

(2008). Negative impact and positive value in caregiving: validation of the COPE index in a six-country sample of carers. The Gerontologist, 48(3), 276–286. https://doi.org/10.1093/geront/48.3.276

Bedard

Molloy

D. W.

Squire

Dubois

Lever

J. A.

O’Donnell

(2001). The Zarit burden interview: A new short version and screening version. The Gerontologist, 41(5), 652–657. https://doi.org/https://doi.org/10.1093/geront/41.5.652

Campos

Yim

I. S.

Busse

(2018). Culture as a pathway to maximizing the stress- buffering role of social support. Hispanic Journal of Behavioral Sciences, 40(3), 294–311. https://doi.org/10.1177/0739986318772490

10.

Comeau

J. A.

(2012). Race/ethnicity and family contact: Toward a behavioral measure of familialism. Hispanic Journal of Behavioral Sciences, 34(2), 251–268. https://doi.org/10.1177/0739986311435899

11.

Coughlin

Denny-Brown

Maurer

Smoot

(2017). Money follows the person demonstration: Overview of state grantee progress, January to December 2016 (Issue December 2016). Mathematica Policy Research.

12.

Crist

J. D.

Garcia-Smith

Phillips

(2006). Accommodating the stranger en casa: How Mexican American elders and caregivers decide to use formal care. Research and Theory for Nursing Practice: An International Journal, 20(2), 109–126.

13.

Crist

J. D.

McEwen

M. M.

Herrera Angelica

A. P.

Kim

S. S.

Pasvogel

Hepworth

J. T.

(2009). Caregiving burden, acculturaltion, familism, and Mexican American Elders’ use of home care services. Research and Theory for Nursing Practice: An International Journal, 23(3), 165–180.

14.

Cruz-Saco

M. A.

López-Anuarbe

(2013). Familism and social inclusion: Hispanics in New London, Connecticut. Social Inclusion, 1(2), 113–125. https://doi.org/10.12924/si2013.01020113

15.

Dilworth-Anderson

Williams

I. C.

Gibson

B. E.

(2002). Issues of race, ethnicity, and culture in caregiving research: A 20-year review. The Gerontologist, 42(2), 237–272.

16.

Escandón

(2006). Mexican American intergenerational caregiving model. Western Journal of Nursing Research, 28(5), 564–585. https://doi.org/10.1177/0193945906286804

17.

Evans

B. C.

Coon

D. W.

Belyea

M. J.

(2014). Worry among Mexican American caregivers of elders. Hispanic Journal of Behavioral Sciences, 36(3), 344–365. https://doi.org/10.1177/0739986314536684

18.

Evercare, & National Alliance for Caregiving. (2008). Hispanic family caregiving in the U.S. findings from a national study (Issue November). https://www.caregiving.org/wp-content/uploads/2020/05/Hispanic_Caregiver_Study_web_ENG_FINAL_11_04_08.pdf

19.

Fabius

C. D.

Brown

Robison

J. T.

(2020). Racial differences in choice and control among older adults: Results from connecticut’ s money follows the person rebalancing demonstration racial differences in choice and control among older adults: Results from connecticut’ s money follows the person rebalancing demonstration. Journal of Aging & Social Policy, 32(2), 172–187. https://doi.org/10.1080/08959420.2019.1589887

20.

Flores

Y. G.

Barker

J. C.

Velasquez

(2010). Beyond familism: Ethics of care of Latina caregivers of elderly parents with dementia. Health Care Women International, 30(12), 1–13. https://doi.org/10.1080/07399330903141252

21.

Fontes

Kelly

(2013). Factors affecting wealth accumulation in Hispanic households: A comparative analysis of stock and home asset utilization. Hispanic Journal of Behavioral Sciences, 35(4), 565–587. https://doi.org/10.1177/0739986313500467

22.

Fukuda

Ohashi

(1997). A guideline for reporting results of statistical analysis in Japanese Journal of Clinical Oncology. Japanese Journal of Clinical Oncology, 27(3), 121–127. https://doi.org/10.1093/jjco/27.3.121

23.

Gallagher-Thompson

Solano

Coon

Arean

(2003). Recruitment and retention of latino dementia family caregivers in intervention research: Issues to face, lessons to learn. The Gerontologist, Special Section, 43(1), 45–51.

24.

Gallegos

M. A.

(2014). Empower the Latino community: Improve Alzheimer’s outreach focus area: Leadership in public healthcare and wellness. De Paul University, https://snlapps.depaul.edu/writing/Showcase15EmpowerLatinoCommunity.pdf

25.

Herrera

A. P.

Lee

Palos

Torres-Vigil

(2008). Cultural influences in the patterns of long-term care use among Mexican American family caregivers. Journal of Applied Gerontology, 27(2), 141–165. https://doi.org/10.1177/0733464807310682

26.

Herrera

A. P.

Mendez-Luck

C. A.

Crist

J. D.

Lee

Warre

Ory

M. G.

Markides

(2013). Psychosocial and cognitive health differences by caregiver status among older Mexican Americans. Community Mental Health Journal, 49(1), 61–72. https://doi.org/10.1007/s10597-012-9494-1

27.

Kalenkoski

C. M.

López-Anuarbe

Korankye

(2022). Differences in the experiential well-being of Hispanics and non-Hispanics engaged in elder care. Journal of Family and Economic Issues, 43(1), 128–137. https://doi.org/10.1007/s10834-021-09763-7

28.

Katchova

(2013). Ordered probit and logit models in Stata. Econometrics Academy. https://sites.google.com/site/econometricsacademy/econometrics-models/ordered-probit-and-logit-models

29.

Knight

B. G.

Sayegh

(2010). Cultural values and caregiving: The updated sociocultural stress and coping model. Journal of Gerontology: Psychological Sciences, 65B(1), 5–13. https://doi.org/10.1093/geronb/gbp096.

30.

Losada

Márquez-González

Vara-García

Barrera-Caballero

Cabrera

Gallego-Alberto

Olmos

Romero-Moreno

(2020). Measuring familism in dementia family caregivers: The revised familism scale. Aging and Mental Health, 24(5), 784–788. https://doi.org/10.1080/13607863.2018.1562537

31.

Losada

Shurgot

G. R.

Knight

B. G.

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 & Mental Health, 10(1), 69–76. https://doi.org/10.1080/13607860500307647

32.

Magaña

(2020). Local voices on health care communication issues and insights on Latino cultural constructs. Hispanic Journal of Behavioral Sciences, 42(3), 300–323. https://doi.org/10.1177/0739986320927387

33.

NAC, AARP Public Policy Institute. (2015). The Hispanic/Latino caregiver. Author. https://www.caregiving.org/wp-content/uploads/2020/05/Caregiving-in-the-US-2015_HispanicLatino_CGProfile.pdf

34.

Neary

S. R.

Mahoney

D. F.

(2005). Dementia caregiving: The experiences of Hispanic/Latino caregivers. Journal of Transcultural Nursing, 16(2), 163–170. https://doi.org/10.1177/1043659604273547

35.

NHCOA. (2017). 2017 Status of Hispanic older adults: Insights from the field – Caregivers edition. National Hispanic Council on Aging. https://www.diverseelders.org/wp-content/uploads/2017/09/2017-Status-of-Hispanic-Older-Adults-FV.pdf

36.

NHCOA. (2018). Proceedings from NHCOA’s Hispanic caregiving thought leaders roundtable. In Cruz

(Ed.), Proceedings from NHCOA’s Hispanic caregiving thought leaders roundtable (pp. 1–5). http://www.nhcoa.org/wp-content/uploads/2018/08/Proceedings-from-Hispanic-Caregiving-Thought-Leaders-Roundtable-New-York-Edition.pdf

37.

Parveen

Morrison

(2009). Predictors of familism in the caregiver role: A pilot study. Journal of Health Psychology, 14(8), 1135–1143. https://doi.org/10.1177/1359105309343020

38.

Phillips

L. R.

Crist

(2008). Social relationships among family caregivers: A cross-cultural comparison between Mexican Americans and non-Hispanic White caregivers. Journal of Transcultural Nursing, 19(4), 326–337. https://doi.org/10.1177/1043659608322499

39.

Sabogal

Marin

Otero-Sabogal

Marin

B. V.

Perez-Stable

E. J.

(1987). Hispanic familism and acculturation: What changes and what doesn’t? Hispanic Journal of Behavioral Sciences, 9(4), 397–412.

40.

Sayegh

Knight

B. G.

(2010). The effects of familism and cultural justification on the mental and physical health of family caregivers. Journal of Gerontology: Pschological Sciences, 66B(1), 3–14. https://doi.org/10.1093/geronb/gbq061.

41.

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(1/2), 133–156. https://doi.org/10.1300/J083v47n01

42.

Smith-Morris

Morales-Campos

Alejandra

Alvarez

Turner

(2012). An anthropology of familismo: On narratives and description of Mexican/immigrants. Hispanic Journal of Behavioral Sciences, 35(1), 35–60. https://doi.org/10.1177/0739986312459508

43.

Steidel

A. G.

Contreras

J. M.

(2003). A new familism scale for use with Latino populations. Hispanic Journal of Behavioral Sciences, 25(3), 312–330. https://doi.org/10.1177/0739986303256912

44.

Stucki

B. R.

Mulvey

(2000). Can aging baby boomers avoid the nursing home? Long-term care insurance for aging in place. https://scholar.google.com/scholar?hl=en&as_sdt=0,7&cluster=15547740468399693674

45.

Suro

(2005). Hispanics: A people in motion. https://www.pewresearch.org/wp-content/uploads/sites/5/reports/40.pdf

46.

Valenzuela

Dornbusch

S. M.

(1994). Familism and social capital in the academic achievent of Mexican origin and Anglo adolescents. Social Science Quarterly, 75(1), 18–36.

47.

Wallace

S. P.

Facio

E. L.

(1987). Moving beyond familism: Potential contributions of gerontological theory to studies of Chicano/Latino aging. Journal of Aging Studies, 1(4), 337–354. https://doi.org/10.1016/0890-4065(87)90009-0