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Journal of Cross-Cultural Gerontology

, Volume 34, Issue 4, pp 355–371 | Cite as

Coping Strategies Utilized by Middle-Aged and Older Latino Caregivers of Loved Ones with Alzheimer’s Disease and Related Dementia

  • Guilherme M. BalbimEmail author
  • Isabela G. Marques
  • Claudia Cortez
  • Melissa Magallanes
  • Judith Rocha
  • David X. Marquez
Original Article
  • 16 Downloads

Abstract

We aimed to explore the coping strategies utilized by Latino caregivers of people with Alzheimer’s disease or related dementia (ADRD). We conducted 16 semi-structured interviews with Latinos family caregivers. The interviews explored the caregivers’ experiences utilizing coping strategies. Coping strategies were identified based on a direct content analysis of the interviews. Participants were 50 to 75 years old, majority female, and from Mexico. The most common coping strategies adopted were: rationalization, social interactions, physical activity, and leisure activities. Other strategies used included avoidance, keeping busy, self-care, and spirituality or faith. Strategies such as using social interactions and spirituality and faith may be rooted in Latino cultural values such as familismo and fatalismo. The possible origin from cultural values might make some of the coping strategies more prevalent or effective in Latinos. Effective interventions aiming to reduce stress in Latino caregivers should prioritize culturally relevant problem-focused coping strategies.

Keywords

Latinos Caregiving Alzheimer’s disease Coping strategies 

Notes

Acknowledgements

We are grateful to all participants of the study. We also acknowledge the work of research assistants Mauricio Garcia and Cindy Jimenez.

Funding Information

This research was supported by the Department of Kinesiology and Nutrition in the University of Illinois at Chicago.

Compliance with Ethical Standards

Conflict of Interest

No potential conflict of interest to be disclosed.

References

  1. Acton, G. J. (2002). Health-promoting self-care in family caregivers. Western Journal of Nursing Research, 24(1), 73–86.  https://doi.org/10.1177/01939450222045716.CrossRefGoogle Scholar
  2. Adams, B., Aranda, M. P., Kemp, B., & Takagi, K. (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(4), 279–301.  https://doi.org/10.1023/A:1019627323558.CrossRefGoogle Scholar
  3. Ai, A. L., Peterson, C., Rodgers, W., & Tice, T. N. (2005). Effects of faith and secular factors on locus of control in middle-aged and older cardiac patients. Aging and Mental Health, 9(5), 470–481.  https://doi.org/10.1080/13607860500142804.CrossRefGoogle Scholar
  4. Alzheimer’s Association. (2019). 2019 Alzheimer’S disease facts and figures. Alzheimer’s Dementia, 15(3), 321–387 Retrieved from https://www.alz.org/alzheimers-dementia/10_signs.CrossRefGoogle Scholar
  5. Anthony, K. P., John Geldhof, G., & Mendez-Luck, C. A. (2017). Characterizing caregiving intensity among Mexican-origin women caregivers. Gerontologist, 57(6), 1084–1092.  https://doi.org/10.1093/geront/gnw090.CrossRefGoogle Scholar
  6. 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(3), 342–354.  https://doi.org/10.1093/geront/37.3.342 CrossRefGoogle Scholar
  7. Arévalo-Flechas, L. C., Acton, G., Escamilla, M. I., Bonner, P. N., & Lewis, S. L. (2014). Latino Alzheimer’s caregivers: What is important to them? Journal of Managerial Psychology, 29(6), 661–684.  https://doi.org/10.1108/JMP-11-2012-0357.CrossRefGoogle Scholar
  8. Bermúdez, J. M., Kirkpatrick, D. R., Hecker, L., & Torres-Robles, C. (2010). Describing Latinos families and their help-seeking attitudes : Challenging the family therapy literature. Contemporary Family Therapy, 32(2), 155–172.  https://doi.org/10.1007/s10591-009-9110-x.CrossRefGoogle Scholar
  9. Borrayo, E. A., Goldwaser, G., Vacha-Haase, T., & Hepburn, K. W. (2007). An inquiry into Latino caregivers’ experience caring for older adults with Alzheimer’s disease and related dementias. Journal of Applied Gerontology, 26(5), 486–505.  https://doi.org/10.1177/0733464807305551.CrossRefGoogle Scholar
  10. Calzada, E. J., Tamis-LeMonda, C. S., & Yoshikawa, H. (2013). Familismo in Mexican and Dominican Families From Low-Income,Urban Communities. Journal of Family Issues, 34(12), 1696–1724.  https://doi.org/10.1177/0192513X12460218.CrossRefGoogle Scholar
  11. Campbell, J. L., Quincy, C., Osserman, J., & Pedersen, O. K. (2013). Coding in-depth Semistructured interviews : Problems of unitization and Intercoder reliability and agreement. Sociological Methods & Research, 42(3), 294–320.  https://doi.org/10.1177/0049124113500475.CrossRefGoogle Scholar
  12. Campesino, M., & Schwartz, G. E. (2006). Spirituality among Latinas/os: Implications of culture in conceptualization and measurement. ANS. Advances in Nursing Science, 29(1), 69–81.CrossRefGoogle Scholar
  13. Carver, C. S., & Scheier, M. F. (1994). Situational coping and coping dispositions in a stressful transaction. Journal of Personality and Social Psychology, 66(1), 595–605.  https://doi.org/10.1037/0022-3514.66.1.184 CrossRefGoogle Scholar
  14. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267–283.  https://doi.org/10.1037/0022-3514.56.2.267 CrossRefGoogle Scholar
  15. Clark, M., & Huttlinger, K. (1998). Elder care among Mexican American families. Clinical Nursing Research, 7(1), 64–81.  https://doi.org/10.1177/105477389800700106 CrossRefGoogle Scholar
  16. Coon, D. W., Mausbach, B., Diego, S., Arguelles, T., & Haley, W. E. (2004). Well-being, appraisal, and coping in Latina and Caucasian female dementia caregivers: Findings from the REACH study. Aging & Mental Health, 8(4), 330–345.  https://doi.org/10.1080/13607860410001709683.CrossRefGoogle Scholar
  17. Cooper, C., Katona, C., Orrell, M., & Livingston, G. (2008). Coping strategies, anxiety and depression in caregivers of people with Alzheimer’s disease. International Journal of Geriatric Psychiatry, 23(9), 929–936.  https://doi.org/10.1002/gps.CrossRefGoogle Scholar
  18. Cox, C., & Monk, A. (1990). Minority caregivers of dementia victims: A comparison of black and Hispanic families. Journal of Applied Gerontology, 9(3), 340–354.  https://doi.org/10.1177/073346489000900308 CrossRefGoogle Scholar
  19. Davila, Y. R., Reifsnider, E., & Pecina, I. (2011). Familismo: Influence on Hispanic health behaviors. Applied Nursing Research, 24(4), e67–e72.  https://doi.org/10.1016/j.apnr.2009.12.003.CrossRefGoogle Scholar
  20. Etters, L., Goodall, D., & Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners, 20(8), 423–428.  https://doi.org/10.1111/j.1745-7599.2008.00342.x.CrossRefGoogle Scholar
  21. Gallagher-Thompson, D., Solano, N., Coon, D., & Arean, P. (2003). Recruitment and Retention of Latino Dementia Family Caregivers in Intervention Research: Issues to Face, Lessons to Learn. The Gerontologist, 43(1), 45–51.  https://doi.org/10.1093/geront/43.1.45 CrossRefGoogle Scholar
  22. García-Alberca, J. M., Cruz, B., Lara, J. P., Garrido, V., Gris, E., Lara, A., & Castilla, C. (2012). Disengagement coping partially mediates the relationship between caregiver burden and anxiety and depression in caregivers of people with Alzheimer’s disease. Results from the MÁLAGA-AD study. Journal of Affective Disorders, 136(3), 848–856.  https://doi.org/10.1016/j.jad.2011.09.026.CrossRefGoogle Scholar
  23. García-Alberca, J. M., Cruz, B., Lara, J. P., Garrido, V., Lara, A., Gris, E., & Gonzalez-Herero, V. (2013). The experience of caregiving: The influence of coping strategies on behavioral and psychological symptoms in patients with Alzheimer’s disease. Aging & Mental Health, 17(5), 615–622.  https://doi.org/10.1080/13607863.2013.765833.CrossRefGoogle Scholar
  24. Geiger, J. R., Wilks, S. E., Lovelace, L. L., Chen, Z., & Spivey, C. A. (2015). Burden among male Alzheimer’s caregivers: Effects of distinct coping strategies. American Journal of Alzheimer’s Disease and Other Dementias, 30(3), 238–246.  https://doi.org/10.1177/1533317514552666.CrossRefGoogle Scholar
  25. Gelman, C. R. (2014). Familismo and its impact on the family caregiving of Latinos with Alzheimer’s disease: A complex narrative. Research on Aging, 36(1), 40–71.  https://doi.org/10.1177/0164027512469213.CrossRefGoogle Scholar
  26. Gelman, C. R. (2010). La Lucha: the experiences of Latino family caregivers of patients with Alzheimer's disease. Clinical Gerontologist, 33(3), 181–193.  https://doi.org/10.1080/07317111003773643 CrossRefGoogle Scholar
  27. Guerrero, L. R., & Mendez-Luck, C. A. (2019). Overcoming a bad day: A qualitative look into the dementia caregiving experiences of Mexican-origin women in East Los Angeles. Journal of Cross-Cultural Gerontology., 1–12.  https://doi.org/10.1007/s10823-019-09373-9.
  28. Hebert, R. S., Weinstein, E., Martire, L. M., & Schulz, R. (2006). Religion, spirituality and the well-being of informal caregivers: A review, critique, and research prospectus. Aging and Mental Health, 10(5), 497–520.  https://doi.org/10.1080/13607860600638131.CrossRefGoogle Scholar
  29. Herrera, A. P., Lee, J. W., Nanyonjo, R. D., Laufman, L. E., & Torres-vigil, I. (2009). Religious coping and caregiver well-being in Mexican-American families. Aging & Mental Health, 13(1), 84–91.  https://doi.org/10.1080/13607860802154507.CrossRefGoogle Scholar
  30. Hilgeman, M. M., Durkin, D. W., Sun, F., Decoster, J., Allen, R. S., Gallagher-thompson, D., & Burgio, L. D. (2009). Testing a theoretical model of the stress process in Alzheimer's caregivers with race as a moderator. Gerontologist, 49(2), 248–261.  https://doi.org/10.1093/geront/gnp015.CrossRefGoogle Scholar
  31. Hirano, A., Suzuki, Y., Kuzuya, M., Onishi, J., Ban, N., & Umegaki, H. (2011). Influence of regular exercise on subjective sense of burden and physical symptoms in community-dwelling caregivers of dementia patients: A randomized controlled trial. Archives of Gerontology and Geriatrics.  https://doi.org/10.1016/j.archger.2010.08.004.CrossRefGoogle Scholar
  32. Hodge, D., & Sun, F. (2012). Positive feeling of caregiving among Latino Alzheimer’s family caregiver: Understanding the role of spirituality. Aging & Mental Health, 16(6), 689–698.  https://doi.org/10.1080/13607863.2012.678481 CrossRefGoogle Scholar
  33. Hollingworth, P., Hamshere, M. L., Moskvina, V., Dowzell, K., Moore, P. J., Foy, C., Archer, N., Lynch, A., Lovestone, S., Brayne, C., Rubinsztein, D. C., Lawlor, B., Gill, M., Owen, M. J., & Williams, J. (2006). Four components describe behavioral symptoms in 1,120 individuals with late-onset Alzheimer’s disease. Journal of the American Geriatrics Society, 54(9), 1348–1354.  https://doi.org/10.1111/j.1532-5415.2006.00854.x.CrossRefGoogle Scholar
  34. Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288.  https://doi.org/10.1177/1049732305276687.CrossRefGoogle Scholar
  35. Huang, M.-F., Huang, W.-H., Su, Y.-C., Hou, S.-Y., Chen, H.-M., Yeh, Y.-C., & Chen, C.-S. (2015). Coping strategy and caregiver burden among caregivers of patients with dementia. American Journal of Alzheimer’s Disease & Other Dementiasr, 30(7), 694–698.  https://doi.org/10.1177/1533317513494446.CrossRefGoogle Scholar
  36. Knight, B. G., & Sayegh, P. (2010). Cultural values and caregiving: The updated sociocultural stress and coping model. Journals of Gerontology - Series B Psychological Sciences and Social Sciences.  https://doi.org/10.1093/geronb/gbp096.CrossRefGoogle Scholar
  37. Jones, R. W., Romeo, R., Trigg, R., Knapp, M., Sato, A., King, D., & Group, D. I. (2015). Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: the DADE study. Alzheimer's & Dementia, 11(3), 280–290.  https://doi.org/10.1016/j.jalz.2014.03.001.CrossRefGoogle Scholar
  38. Koerner, S. S., & Shirai, Y. (2019). Latina / o family caregivers ’ reactions to limited help from relatives : From frustration to resilience. Journal of Family Nursing, 1–20.  https://doi.org/10.1177/1074840719867706.
  39. Kramer, B. J. (1993). Expanding the conceptualization of caregiver coping: The importance of relationship-focused coping strategies. Family Relations, 42(4), 383-391. https://www.jstor.org/stable/585338 CrossRefGoogle Scholar
  40. Lambert, S. D., Duncan, L. R., Kapellas, S., Bruson, A. M., Myrand, M., Santa Mina, D., Culos-Reed, N., & Lambrou, A. (2016). A descriptive systematic review of physical activity interventions for caregivers: Effects on caregivers’ and care recipients’ psychosocial outcomes, physical activity levels, and physical health. Annals of Behavioral Medicine, 50(6), 907–919.  https://doi.org/10.1007/s12160-016-9819-3.CrossRefGoogle Scholar
  41. Levin, J. S., Markides, K. S., & Ray, L. A. (1996). Religious attendance and psychological well-being in Mexican Americans: A panel analysis of three-generations data. The Gerontologist, 36(4), 454–463.  https://doi.org/10.1093/geront/36.4.454 CrossRefGoogle Scholar
  42. Llanque, S. M., & Enriquez, M. (2012). Interventions for Hispanic caregivers of patients with dementia : A review of the literature. American Journal of Alzheimer’s Disease & Other Dementias®, 27(1), 23–32.  https://doi.org/10.1177/1533317512439794.CrossRefGoogle Scholar
  43. Loi, S. M., Dow, B., Ames, D., Moore, K., Hill, K., Russell, M., & Lautenschlager, N. (2014). Physical activity in caregivers: What are the psychological benefits? Archives of Gerontology and Geriatrics, 59(204–210).  https://doi.org/10.1016/j.archger.2014.04.001.CrossRefGoogle Scholar
  44. Lopez, J., Romero-Moreno, R., Marquez-González, M., & Losada, A. (2012). Spirituality and self-efficacy in dementia family caregiving: Trust in god and in yourself. International Psychogeriatrics, 24(12), 1943–1952.  https://doi.org/10.1017/S1041610212001287.CrossRefGoogle Scholar
  45. Losada, A., Pérez-Peñaranda, A., Rodriguez-Sanchez, E., Gomez-Marcos, M. A., Ballesteros-Rios, C., Ramos-Carrera, I. R., Campo-de la Torre, M. A., & García-Ortiz, L. (2010). Leisure and distress in caregivers for elderly patients. Archives of Gerontology and Geriatrics, 50(3), 347–350.  https://doi.org/10.1016/j.archger.2009.06.001.CrossRefGoogle Scholar
  46. Márquez-González, M., López, J., Romero-Moreno, R., & Losada, A. (2012). Anger, spiritual meaning and support from the religious community in dementia caregiving. Journal of Religion and Health, 51(1), 179–186.  https://doi.org/10.1007/s10943-010-9362-7 CrossRefGoogle Scholar
  47. Mendez-Luck, C. A., & Anthony, K. P. (2019). Burden and bad days among Mexican-origin women caregivers. The Gerontologist, In press.Google Scholar
  48. Mendez-luck, C. A., Applewhite, S. R., Lara, V. E., & Toyokawa, N. (2016). The concept of Familism in the lived experiences of Mexican-origin caregivers. Journal of Marriage and Family, 78(3), 813–829.  https://doi.org/10.1111/jomf.12300.CrossRefGoogle Scholar
  49. Morano, C. L. (2003). Appraisal and coping? Moderators or mediators of stress in Alzheimer’s disease caregivers? Social Work Research, 27(2), 116.  https://doi.org/10.1093/swr/27.2.116 CrossRefGoogle Scholar
  50. Moreira, T., Hernandez, D. C., Scott, C. W., Murillo, R., Vaughan, E. M., & Johnston, C. A. (2018). Susto, coraje, y fatalismo: Cultural-bound beliefs and the treatment of diabetes among socioeconomically disadvantaged Hispanics. American Journal of Lifestyle Medicine, 12(1), 30–33.  https://doi.org/10.1177/1559827617736506.CrossRefGoogle Scholar
  51. National Hispanic Council on Aging. (2017). 2017 status of Hispanic older adults : Insights from the field – Caregivers Edition. Washington.Google Scholar
  52. Pinquart, M., & Sörensen, S. (2005). Ethnic differences in stressors, resources , and psychological outcomes of family caregiving. The Gerontologist, 45(1), 90–106.  https://doi.org/10.1093/geront/45.1.90 CrossRefGoogle Scholar
  53. Ramos, B. M. (2004). Culture, ethnicity, and caregiver stress among Puerto Ricans. Journal of Applied Gerontology, 23(4), 469–486.  https://doi.org/10.1177/0733464804271281.CrossRefGoogle Scholar
  54. Rote, S., Angel, J., & Hinton, L. (2019). Characteristics and consequences of family support in Latino dementia care. Journal of Cross-Cultural Gerontology.  https://doi.org/10.1007/s10823-019-09378-4
  55. Shurgot, G. S. 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(3), 183–194.  https://doi.org/10.1146/annurev.eco.CrossRefGoogle Scholar
  56. Sun, F., & Hodge, D. R. (2014). Latino Alzheimer’s disease caregivers and depression: Using the stress coping model to examine the effects of spirituality and religion. Journal of Applied Gerontology, 33(3), 291–315.  https://doi.org/10.1177/0733464812444462.CrossRefGoogle Scholar
  57. Thompson, L. W., Solano, N., Kinoshita, L., Coon, D. W., Mausbach, B., & Gallagher-Thompson, D. (2002). Pleasurable activities and mood: Differences between Latina and Caucasian dementia family caregivers. Journal of Mental Health and Aging, 8(3), 211–224.Google Scholar
  58. Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357.  https://doi.org/10.1093/intqhc/mzm042 CrossRefGoogle Scholar
  59. Umaña-Taylor, A. J., Updegraff, K. A., & Gonzales-Backen, M. A. (2011). Mexican-origin adolescent mothers’ stressors and psychosocial functioning: Examining ethnic identity affirmation and Familism as moderators. Journal of Youth and Adolescence, 40(2), 140–157.  https://doi.org/10.1007/s10964-010-9511-z.CrossRefGoogle Scholar
  60. Valle, R., Yamada, A. M., & Barrio, C. (2004). Ethnic differences in social network help-seeking strategies among Latino and Euro-American dementia caregivers. Aging & Mental Health, 8(6), 535–543.  https://doi.org/10.1080/13607860410001725045.CrossRefGoogle Scholar
  61. Valle, R. (1994). Culture-fair behavioral symptom differential assessment and intervention in dementing illness. Alzheimer’s Disease and Associated Disorders, 8, Suppl 3, 21–45.CrossRefGoogle Scholar
  62. Wu, S., Vega, W. A., Resendez, J., & Jin, H. (2016). Latinos & Alzheimer’s Disease: New Numbers Behind the Crisis. Retrieved from http://www.usagainstalzheimers.org/sites/default/files/Latinos-and-AD_USC_UsA2-Impact-Report.pdf

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Authors and Affiliations

  1. 1.Department of Kinesiology & NutritionUniversity of Illinois at ChicagoChicagoUSA
  2. 2.School of Exercise, Physical and Health EducationUniversity of VictoriaVictoriaCanada
  3. 3.Center for Early Learning Public HealthUniversity of ChicagoChicagoUSA
  4. 4.College of MedicineUniversity of IllinoisRockfordUSA
  5. 5.Social Work ProgramNortheastern Illinois UniversityChicagoUSA

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