Ethnicity and Time to Institutionalization of Dementia Patients: A Comparison of Latina and Caucasian Female Family Caregivers

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 52; no. 7; pp. 1077 - 1084
• Main Authors: Mausbach, Brent T., Coon, David W., Depp, Colin, Rabinowitz, Yaron G., Wilson-Arias, Esther, Kraemer, Helena C., Thompson, Larry W., Lane, Geoffrey, Gallagher-Thompson, Dolores
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Inc 01.07.2004; Blackwell; Wiley Subscription Services, Inc
• Subjects: Admissions; Aged; Alzheimer's caregiving; Alzheimer's disease; Biological and medical sciences; California; Caregivers; Caregivers - psychology; caregiving appraisal; Carers; Comparative analysis; Cross-Cultural Comparison; Cultural differences; cultural values; Decision making; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Delay; Dementia; Dementia - ethnology; Dementia - nursing; Elderly people; Ethnic differences; European Continental Ancestry Group - psychology; Family environment. Family history; Female; Females; Hispanic American people; Hispanic Americans; Hispanic Americans - psychology; Humans; Institutionalization - statistics & numerical data; Latino issues; Longitudinal studies; Medical sciences; Neurology; nursing home; Nursing homes; Proportional Hazards Models; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Social psychiatry. Ethnopsychiatry; Time Factors; USA; White people; Women; United States > US; San Francisco California; Human; Nervous system diseases; Family study; Caregiver; Time; Ethnic group; Cerebral disorder; Senile dementia; Central nervous system disease; Family environment; Female; Degenerative disease; Caucasoid; Elderly; Comparative study; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2004.52306.x

Objectives: To compare rates of institutionalization of dementia patients cared for by Latina and Caucasian female caregivers and to explore which caregiver and care‐recipient characteristics predicted institutionalization. Design: Longitudinal. Setting: San Francisco Bay area, California. Participants: Two hundred sixty‐four female caregivers of dementia patients (154 Caucasian women, 110 Latinas) who participated in an intervention project designed to reduce caregiver stress and may represent a sample that is more stressed and motivated than a general sample of caregivers. Measurements: Number of days between baseline interview and institutionalization was recorded over an 18‐month period. Kaplan‐Meier survival analysis with the log rank statistic was used to test for ethnic differences in time to institutionalization. Cox regression analyses were conducted to determine whether care‐recipient or caregiver characteristics (e.g., care‐recipient age and memory and behavior problems; caregiver depression, years of education, income, and views of the caregiving role) significantly interacted with ethnicity to explain time to institutionalization. Results: Latinas delayed institutionalization significantly longer than their Caucasian counterparts; care‐recipient characteristics or caregiver demographics did not explain these results, although Latinas who identified greater benefits or more‐positive aspects of the caregiving process at baseline were less likely to institutionalize their loved one than those who reported fewer benefits of caregiving. Less‐acculturated Latinas were significantly more likely to identify positive aspects of caregiving than more‐acculturated Latinas. Conclusion: Latina dementia caregivers delay institutionalization significantly longer than female Caucasian caregivers. In addition, Latino cultural values and positive views of the caregiving role are important factors that may significantly influence their decision to institutionalize loved ones with dementia.