Abstract
Introduction:
Latina caregivers face significant physical and mental health risks due to the demands of caregiving. The decision to become a caregiver is often influenced by various factors including cultural values such as familismo and marianismo. It is essential that caregivers recognize the importance of self-care to prevent burnout. Without self-care, caregivers face an increased risk of stress, which can negatively affect physical and emotional health.
Methods:
A qualitative approach using focus groups to explore Latina caregivers’ understanding and engagement in self-care.
Results:
Findings suggested that participants understand the need for self-care; however, family and cultural needs were prioritized. When time permitted, participants engaged in self-care activities.
Discussion:
The values of familismo, marianismo, and fatalismo were significant not only in the decision to serve as caregivers but also in the decision to take time for self-care. Understanding cultural dynamics is needed in developing culturally sensitive interventions for Latina caregivers.
Introduction
Latina caregivers, who predominantly serve as informal caregivers, face significant physical and mental health risks due to the demanding nature of caregiving. Many experience burnout, exhaustion, and musculoskeletal issues, particularly those providing continuous care without structured respite. The AARP and National Alliance for Caregiving (2020) reported that 32% of Hispanic caregivers reported high levels of emotional stress, and about 17% of them reported their health had gotten worse (p. 50). Despite these reported stressors for caregivers, many individuals still choose to serve as a caregiver for different reasons, such as economic necessity or a deep desire to care for and support a loved one, including cultural values of familial obligation such as familismo and marianismo (Garcia et al., 2024). Regardless of motivation, it is essential for caregivers to recognize the importance of self-care in preventing burnout and safeguarding their well-being. Without adequate self-care, caregivers face an increased risk of stress, which can negatively affect both physical and emotional health. Longoria et al. (2020) studied practitioners’ perceptions of care and found that among Latino families, the daughter was often identified as the most instrumental family member regarding care for their older family member.
Caregivers often overlook stress. Stress can manifest physically and/or emotionally, especially if the caregiver does not have any support, feels obligated to provide the care, and has no options for respite. Adelman et al. (2014) found that being female, having low educational attainment, sharing a home with a loved one, social isolation, and a sense of obligation were all risk factors for caregiver burden. Akdogan and Ilhan’s (2024) study found that risks for caregiver burden included being female or reporting poor mental health. For Latinas (any female of Latin descent), there is a sense of obligation to provide care for loved ones (Friedemann & Buckwalter, 2014; Mendez-Luck & Anthony, 2016); thus, the effects of caregiver stress can be concerning. In addition, Latinas will sometimes distinguish between “care” and “caring,” positing that “Latino caregivers note a difference between care (things that you can hire other people to do) and caring (the extra things one does for a loved one)” (I. L. Martinez & Acosta Gonzalez, 2022, p. 1750). Moreover, Latinas may search for additional support when the caregiving needs increase; finding formal support that meets their expectations of “caring” can be a challenge. Wolff et al. (2016) found that only 25% of caregivers reported receiving any type of support services when they were serving as caregivers for loved ones. Given these findings, it is concerning that Latinas who serve as caregivers will be even more vulnerable to caregiver stress or burden.
Cultural values such as marianismo, familismo, and machismo continue to influence Latino caregivers’ approach to self-care. Traditional beliefs like fatalismo (acceptance of fate) also contribute to not seeking help outside the family (Anthony et al., 2017). Many caregivers, particularly women, adhere to marianismo, which is the cultural expectation that women should be self-sacrificing and should prioritize the needs of their family over their well-being. This cultural norm contributes to a reluctance to seek professional care or external support, as caregiving is often viewed as a family responsibility (Garcia et al., 2024). The National Hispanic Council on Aging (NHCOA) (2025) describes familismo as a “strong sense of dedication and loyalty to family members, love and respect that is ingrained generationally, both within and beyond a single household” (para. 1). They further describe specific behaviors such as sharing a home with multiple generations, supporting distant family members, and maintaining high regard for elders in the family. This value relates to Latino families’ preference for informal caregiving, especially when faced with barriers such as lack of health insurance, transportation, and financial resources. Finally, the value of machismo focuses on the male’s role as strong and emphasis is placed on protecting the family (Marques et al, 2017). The male is seen as protective but not nurturing, which is required for caregiving.
Latina caregivers often juggle multiple roles, including being a spouse or partner, parent, worker, and friend. Each of these roles may involve various responsibilities, such as providing transportation, offering a listening ear, resolving conflicts, or spending time to offer support. All these responsibilities can be overwhelming, especially with caregiving added.
Pharr et al. (2014) examined how cultural values affect the experiences of family caregivers across different ethnic groups, finding significant cultural differences across multiple ethnicities (e.g., African American, Asian American, Hispanic American, and European Americans) in their perceptions, responsibilities, and management of caregiving within their families. In addition, caregiving was seen as a natural duty rather than a role that required external support or personal care. Sabo and Chin’s (2020) systematic review found that many caregivers often overlooked their own health care needs in favor of their care recipients’ needs; however, their findings supported the belief that caregivers’ well-being was “instrumental in health outcomes for care recipients” (p. 580).
This study is significant because Latina caregivers are often underrepresented in research, even though they frequently face cultural, social, linguistic, and socioeconomic challenges. Latina caregivers are one of the largest groups of unpaid caregivers. The decision to serve as a caregiver is often shaped by values such as familismo and marianismo, which can intensify both the emotional burden and resilience. The study shows how cultural expectations, access barriers, and support systems can influence caregiving stress as well as coping strategies. This advances current knowledge by informing more culturally responsive interventions and policies related to caregiving.
This study explored Latina caregivers’ understanding and engagement in self-care. We sought to answer two key questions: (1) How do Latina caregivers prioritize self-care? (2) What self-care activities do they engage in? Understanding these perspectives can inform the development of culturally responsive interventions to support Latina caregivers in maintaining their well-being while fulfilling their caregiving responsibilities.
Method
Ethical Considerations
After receiving approval from the IRB at the University of Texas Rio Grande Valley, we conducted focus groups in private conference rooms at three agency facilities. The researchers obtained written, informed consent from all participants in the study.
Research Design
We decided that the qualitative approach was best to study Latina caregivers (Creswell & Poth, 2024; Padgett, 2016). With the study concentrating on Latina caregivers, conducting focus groups was chosen because group interaction facilitates open communication and improves the caregivers’ ability to express their experiences (Creswell & Poth, 2024; Krueger & Casey, 2015). In addition, focus groups should occur in nonthreatening environments with a group of individuals who share certain characteristics to allow for a good group dynamic and greater self-disclosure (Krueger & Casey, 2015). The research team conducted focus groups from June to August 2022. The research questions were: (1) How do caregivers prioritize self-care? (2) What do caregivers do for self-care?
Sample and Setting
To understand the ways in which Latina females experience caregiving and find meaning for their mental health and health experiences, we sought to recruit Latina adult women from South Texas. To be eligible to participate, individuals needed to: self-identify as a Latina, currently serve or have served as caregivers of at least one loved one and live along the South Texas-México border. Participants could speak English, Spanish, or be Bilingual as the focus groups were held in the language that participants were most comfortable with. Focus groups were held at three different locations: Laredo, McAllen/Edinburg, and Brownsville.
Procedures
To recruit participants, we created a flyer that was in English and Spanish. The flyer explained the research study and was distributed by the researchers via email and social media. The flyer was emailed to community providers so they could share the information with individuals they thought would be interested in the study. Participants were given a $25 gift card for Walmart or Target as compensation for their time. Interested participants were invited to one focus group held in three locations. In Laredo, there were 18 participants. In McAllen/Edinburg, there were six participants and eight in Brownsville. Attendance was not limited to any specific number.
Data Collection
Two researchers were the moderators for each focus group. The moderators followed a list of semi-structured guiding questions and probed for examples, clarification, and/or details from group participants. The questions centered on caregivers of patients with Alzheimer’s disease and other types of dementia as well as other chronic or terminal diseases. Questions included in the guide asked about the participant’s experience as a caregiver, the influence of culture on their caregiving, and their beliefs about spirituality. Other questions focused on difficult times while caregiving, the impact of caregiving on their life, and self-care. We began each focus group with the following question: Please share with us how many years you have been a caregiver. A list of questions is included in Table 1.
Semi-structured Questions for Caregivers of Alzheimer’s Patients.
Focus group participants sat around the conference room table and were able to see one another. Two moderators conducted focus groups in the language that the participants preferred (English, Spanish, or a combination of both). All participants at all sites confirmed they were bilingual and felt comfortable speaking both English and Spanish. Each of the researchers had experience facilitating focus groups. Focus group discussions lasted an average of 60 min, and they were recorded for transcription purposes (Krueger & Casey, 2015).
Data Analysis
We employed ethnographic content analysis (Altheide & Schneider, 2013; Stark & Roberts, 2005) to assess the transcripts. It was selected because it focuses on understanding cultural context more in depth. Ethnographic content analysis “centers” on the identification of concepts, collection of narratives, and emergent patterns and categories through repeated study of the content or text. Ethnographic content analysis followed a recursive and reflexive movement between the narratives and the interpretation of those narratives by the different members of the research team. Analysis began immediately after the focus group discussions. The research team did not need to make any adjustments to the guiding questions or research protocol. We completed the content analysis, including conceptual refinement and identification of pertinent categories. Finally, we integrated and interpreted the study findings. The aim was to be systematic and analytic, but not rigid. The process was oriented toward clear description and definition. Four coders independently identified keywords, phrases, meanings, and concepts. We then met and discussed similarities and potential connections among keywords, phrases, and concepts, within and across the focus groups. Coding discrepancies were reconciled through these discussions.
Rigor and Trustworthiness
To ensure trustworthiness or rigor in this study, we used an audit trail and peer debriefing. We met bi-weekly for peer debriefing sessions to assess the data analysis of the study. These sessions provided time for feedback on interpretations and an opportunity to consider other ideas for data analysis (Creswell & Poth, 2024; Padgett, 2016). These sessions helped us determine when the analysis reached saturation. The audit trail consisted of steps taken in data collection and data analysis. The audit trail served as a roadmap of the study and a time to look back at the steps in this process and examine directions to consider in the analysis.
Results
A total of 32 women participated, ranging in age from 20 to 65—18 in Laredo, six in McAllen/Edinburg, and eight in Brownsville. The research team did not request confirmation of attendance; thus, there was no way of knowing how many people to expect at each location. All participants stated they were current and/or past caregivers of family members, including parents, spouses, children, and siblings. Four main themes emerged, including (1) prioritization of caregiving, (2) the lack of support and family involvement, (3) the feelings of guilt related to cultural obligations, and (4) self-care strategies. Sometimes, caregivers are overlooked and are not asked how they are doing or feeling. This leads to caregivers feeling they do not have the support of others they can count on for respite care. One participant noted, “So, it’s really hard, and you don’t get a break, like nobody asks you, ‘How’s your day? How are you doing?’ Cause sometimes you do need a break.”
Other participants admitted they did not take time for self-care, while others said they did not take advantage of respite care due to feeling obligated to take care of their loved ones. One participant had a sibling who offered respite from time to time, “If you need to go somewhere, or you need to get out of the house I’ll take care of them, she would offer, but I felt like I had to do it.” Ultimately, participants said they were more likely to prioritize obligation and sacrifice over self-care.
Prioritization of Caregiving
Participants consistently reported placing caregiving responsibilities above their own well-being. Many expressed that caregiving was their primary focus, often at the expense of personal time and health. Even when respite care was offered, some participants declined due to a sense of duty. Ultimately, participants acknowledged that they were more likely to prioritize their sense of obligation over their need to engage in self-care.
The Lack of Support and Family Involvement
A recurring theme was the absence of family support. Participants described feeling isolated in their caregiving roles. One stated, “I didn’t have the support of my siblings to take care of my mom. I just went to work, and I went home. I did what I had to do. I didn’t do anything else to take care of myself.” Another participant added, “Everybody has a hundred reasons why they can’t come.” This lack of involvement often led caregivers to sacrifice personal goals, such as pursuing education, getting married, or nurturing other significant relationships.
The Feelings of Guilt Related to Cultural Obligations
Feelings of guilt, often rooted in cultural expectations, were prevalent. Participants felt obligated to prioritize caregiving, even when it meant missing out on family time or personal activities. One participant shared, “You’re always tied up with your parents. They understood, but it was hard on them.” Another reflected on missing time with her daughters: “We want to go to the movies. We want to take you out shopping, Mother, and if I did go, I would just run.” These experiences highlight the internal conflict between cultural values and personal needs.
Self-Care Strategies
Despite the challenges, participants identified various self-care strategies. These were grouped into three subthemes: scheduled self-care, creative expression, and support networks.
Scheduled Self-Care
Some participants emphasized the importance of planning respite time. One shared, “We just knew that the weekend that we were off, that’s when we did whatever we needed to do . . . we’re going to be in charge of mom.” However, others struggled to find time due to inconsistent family support.
Creative Expression
Creative activities were a vital outlet for many. Participants engaged in music, reading, writing, journaling, gardening, and even painting. One participant said, “I go walking, I do a little bit of yoga . . . I read a lot and help other people with their problems.” Another noted, “I do a lot of journaling.”
Music was a strategy participants found especially therapeutic: “I don’t like to express emotions in front of people, but I can do it (sing) in my car. That helps.” Others found joy in shared activities with loved ones, such as gardening or laughing together.
Support Networks
Support from friends, religious groups, or caregiver support groups was noted as essential for caregiving. One participant shared, “If I feel depressed or something, I call one of my friends and that cheers me up.” In some cases, participants became sources of support for others, extending their caregiving roles into their social circles.
Participants consistently prioritized caregiving responsibilities over their own well-being, often sacrificing personal time, health, and emotional needs. Despite opportunities for respite, many declined due to a strong sense of duty and cultural obligation. The lack of family support intensified feelings of isolation, with caregivers frequently assuming sole responsibility and foregoing personal goals.
Cultural expectations contributed to pervasive guilt, as participants struggled to balance caregiving with personal and familial relationships. Nevertheless, some caregivers developed self-care strategies, including scheduled respite, creative expressions (e.g., journaling, music, gardening), and reliance on support networks such as friends and religious groups. These strategies provided emotional relief and helped mitigate the stress of caregiving, even though access and consistency varied.
Discussion
The Western view of self-care generally emphasizes individual responsibility for maintaining personal well-being and health. It is rooted in a combination of psychological, physical, and emotional health and is often framed in terms of individual autonomy, self-improvement, and personal empowerment (N. Martínez et al., 2021). The researchers found that Latina caregivers in this study did not follow a formal means of self-care as defined by the Western view of self-care practices. The Western self-care practices were often overlooked by Latina caregivers. For Latina caregivers in the study, self-care was not a primary focus because caregiving was seen as a cultural obligation. Self-care was seen as a secondary priority to their cultural responsibilities, making them more susceptible to stress, strain, and burnout.
The value of familismo was significant in the decision to engage in self-care. According to Lopez-Tamayo et al. (2017), the “main aspects of familismo are feelings of mutual obligation, reciprocity, and solidarity towards one’s family members” (p. 2). Culture plays a significant part in this obligation to be a caregiver. Cultural obligation also contributed to the lack of priority that caregivers assign to self-care and influenced the actions participants took for self-care.
Marianismo and fatalismo were also two values that were important to participants that influenced their self-care actions. According to the American Psychological Association (2018), marianismo refers to “an idealized traditional feminine gender role characterized by submissiveness, selflessness, chastity, hyper femininity, and acceptance of machismo in males” (para. 1). While not every part of this definition was identified as a reason for feeling obligated to be a caregiver, many of the participants described selflessness as their reason for doing it. In addition, they identified “being a female” as the reason they were “expected” to provide the caregiving. Fatalismo refers “to a general belief that the course of fate cannot be changed and that life events are beyond one’s control” (Abraido-Lanza et al., 2007, p. 2). Some participants identified lack of support and others identified cultural obligation—both are examples of the value of fatalismo.
While the participants agreed they needed self-care, they generally explained it was difficult to prioritize it amid the many duties of being a caregiver. Overall, they stated that scheduling self-care seemed to be the best way to ensure they would have some time for themselves, even if it was just for a short time. It is important to note, however, that many of the participants only felt comfortable allowing for this if it was another family member who was taking over the caregiving. This reflects the literature, which suggests that many Latino individuals believe caregiving is a familial obligation, and there is shame if the caregiving is provided by others (Falzarano et al., 2022; Llanque & Enriquez, 2012; Lugli, 2023; I. L. Martinez & Acosta Gonzalez, 2022; Mendez-Luck & Anthony, 2016; Sehar et al., 2022; Tran et al., 2023).
The participants in the study identified how music can serve as a source for self-care. This was similar to the literature, which has shown that music can be used in several ways to help enhance mood including singing, listening to music, dancing, and playing a musical instrument (Dingle et al., 2021; Rebecchini, 2021; Reynolds, 2023). The literature is mixed on the benefits of journaling, where there have been some positive outcomes, but the precise use and effect is unclear (Smyth et al., 2018; Sohal et al., 2022). Exercise was also an activity that participants engaged in for self-care. This finding was consistent with numerous studies which show that exercise is a good way to minimize stress (Mahindru et al., 2023; Mikkelsen et al., 2017).
A limitation of this study is that it was conducted in one state and may not be applicable to other states. However, we have described how we conducted our study, so others could conduct a similar study to determine if our findings are transferable to other states. The study sample was purposive, which makes it difficult to generalize to all Latina caregivers or a larger population. Another limitation was the transferability of this data, as these findings may not be applicable depending on the context, setting, or population. However, the researchers feel the findings are significant in contributing to the knowledge base of Latina caregivers.
Conclusion
These findings highlight the need for culturally designed interventions that focus on how self-care practices not only improve the health of Latina caregivers’ health but also enhance the quality of caregiving services. In addition, it is important to emphasize that Western views of self-care may not align with the Latina caregivers’ views of self-care. Therefore, self-care talk should focus on self-care practices that align with their cultural beliefs of familismo, marianismo, and fatalismo to increase their engagement in self-care practices.
Overall, the study found that Latina caregivers continue to internalize caregiving as a moral and cultural obligation, often at the expense of their own well-being. While participants described engaging in self-care practices such as physical activity, prayer, reading, journaling, and sharing special moments with loved ones, these efforts were typically brief and infrequent. Extended periods of rest or time away from caregiving responsibilities were rare.
Participants identified two interconnected barriers to sustained self-care: the lack of alternative caregiver support and the cultural expectation that caregiving is primarily a woman’s responsibility within the family. These factors made it difficult to disengage from caregiving, even temporarily. Many expressed that declining caregiving duties would violate deeply held cultural values such as marianismo (expectation that the female family members are the best people indicated to provide the care for the loved one) and familismo (familial obligation). While these values provide strength and identity, they also contribute to a sense of duty that complicates boundary-setting and the prioritization of personal needs.
Culturally relevant messaging that reframes self-care as a demonstration of resilience rather than an act of selfishness is key to enhancing the Latina caregiver’s willingness to engage in self-care practices. Such messaging, combined with increased access to community-based support systems, can empower caregivers to prioritize their own health without compromising their cultural values. Supporting Latina caregivers in navigating the tension between care and self-care is essential not only for their individual well-being but also for the long-term health and stability of the loved ones they care for.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
